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HeLP-BAG score: a novel data-driven scoring system for predicting post-operative 30-day mortality using 24-hour
Hyun Sik Kim1, Hyo Seop Shin2, Jinhyong Goh3,4
1Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea.
BMC Anesthesiology
|June 9, 2026
Summary
A new risk score, HeLP-BAG, effectively screens for 30-day postoperative mortality using routine data. This simple tool shows robust performance across various patient groups, aiding clinical decision-making.
Area of Science:
- Medical Informatics
- Surgical Outcomes Research
- Predictive Analytics
Background:
- Preoperative risk stratification is crucial but existing tools are often complex or population-specific.
- There is a need for a simple, broadly applicable score for 30-day postoperative mortality prediction.
- Routinely available variables are underutilized for comprehensive risk assessment.
Purpose of the Study:
- To develop and validate the HeLP-BAG score, a novel, simple, and interpretable tool for screening 30-day postoperative mortality.
- To ensure broad applicability across diverse surgical patient populations.
- To compare the HeLP-BAG score's performance against established systems and machine learning models.
Main Methods:
- Development of the HeLP-BAG score using three large, matched surgical cohorts (n=24,617 per dataset).
- Selection of ten routinely available preoperative variables based on clinical relevance and statistical performance.
- Evaluation of model performance using Area Under the Receiver Operating Characteristic Curve (AUROC) in a combined validation cohort (n=98,468).
Main Results:
- The HeLP-BAG score, comprising ten variables including ICU admission, age, and key physiological markers, achieved an AUROC of 0.873.
- Performance was comparable to ASA-PS (0.865) and superior to SAPS3 (0.831), particularly in high-risk subgroups like emergency surgery and older patients.
- A web-based calculator was developed for easy bedside implementation, with mortality increasing monotonically with score elevation.
Conclusions:
- The HeLP-BAG score offers a simple, interpretable, and broadly applicable method for screening 30-day postoperative mortality.
- Its consistent performance across diverse surgical populations makes it a valuable tool for preoperative risk stratification.
- The score facilitates bedside implementation, potentially improving patient management and outcomes.