Pediatric anesthesia & critical care
Development and External Validation of a Novel In-hospital Mortality Model after Pediatric Congenital Heart Surgery: A Multicenter Retrospective Cohort Study
Authors' conclusion
The four major traditional models were only moderately effective in predicting in-hospital mortality after congenital heart surgery in the Chinese setting.
Study context
- Population
- Consecutive pediatric patients undergoing congenital heart surgery, Shanghai Children's Medical Center 2015–2021 (development) and Beijing Fuwai Hospital 2020–2021 (external validation)21,855 development
- Exposure
- Novel model vs Aristotle Basis Complexity (ABC) score, RACHS-1 categories, STAT score and STAT categories for predicting in-hospital mortality
- Outcome
- In-hospital mortality prediction (AUROC and Brier score)
Methodological detailsmulticentre, prediction model development and external validation
- Multicentre
- Prediction model development and external validation
Main finding
As reported in the abstract
In-hospital mortality prediction (AUROC, Brier score)
| Group | AUROC | AUROC with preoperative covariates |
|---|---|---|
| ABC score | 0.778 | 0.860 |
| RACHS-1 categories | 0.685 | 0.844 |
| STAT score | 0.808 | 0.856 |
| STAT categories | 0.784 | 0.864 |
AUROC
ABC score0.778
RACHS-1 categories0.685
STAT score0.808
STAT categories0.784
AUROC with preoperative covariates
ABC score0.860
RACHS-1 categories0.844
STAT score0.856
STAT categories0.864
- Best-performing model (age, height, oxygen support, previous cardiac operation, emergency surgery, STAT categories): AUROC, development cohort
- 0.864
- Best-performing model: Brier score, development cohort
- 0.00977
- Best-performing model: AUROC, external validation cohort
- 0.860
- Best-performing model: Brier score, external validation cohort
- 0.00654
Observational data: associations, not effects.
Original publication
Development and External Validation of a Novel In-hospital Mortality Model after Pediatric Congenital Heart Surgery: A Multicenter Retrospective Cohort Study. Anesthesiology. Published 16 April 2025. doi:10.
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