ArticleBMJ open2018
Development of the Combined Assessment of Risk Encountered in Surgery (CARES) surgical risk calculator for prediction of postsurgical mortality and need for intensive care unit admission risk: a single-center retrospective study.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04041076 (Validation of Postoperative Mortality Prediction for Elective Major Surgical Operation With Existing Risk Calculators Based on Preoperative Parameters), which is not on this map. Cited by 25 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Validation of Postoperative Mortality Prediction for Elective Major Surgical Operation With Existing Risk Calculators Based on Preoperative Parameters
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The comparative and added prognostic value of biomarkers to the Revised Cardiac Risk Index for preoperative prediction of major adverse cardiac events and all-cause mortality in patients who undergo noncardiac surgery.The Cochrane database of systematic reviews · 2021Pooled it
- Preoperative inflammatory markers for prediction of postoperative clinical outcomes: a retrospective cohort study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2025Article
- Predictive value of the American college of surgeons "surgical risk calculator" (ACS-NSQIP SRC) for plastic and reconstructive surgery: a validation study from an academic tertiary referral center in Germany.Patient safety in surgery · 2025Article
- Planning intensive care unit admission after elective major abdominal surgery: good clinical practice document by SIAARTI-SIC-ANIARTI.Journal of anesthesia, analgesia and critical care · 2025Review
- Article
- Association of preoperative red blood cell width and postoperative 30-day mortality in patients undergoing non-cardiac surgery: a retrospective cohort study using propensity-score matching.Perioperative medicine (London, England) · 2024Article
- A simple machine learning model for the prediction of acute kidney injury following noncardiac surgery in geriatric patients: a prospective cohort study.BMC geriatrics · 2024Article
- The impact of preoperative serum lactate dehydrogenase on mortality and morbidity after noncardiac surgery.Scientific reports · 2024Article
- Preoperative anemia in older individuals undergoing major abdominal surgery is associated with early postoperative morbidity: a prospective observational study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024Observational
- Article
- Development of the PIP score: A metric for predicting Intensive Care Unit admission among patients undergoing emergency laparotomy.Surgery in practice and science · 2022Article
- A risk scoring system integrating postoperative factors for predicting early mortality after major non-cardiac surgery.Clinical and translational science · 2022Article
- Discordant American Society of Anesthesiologists Physical Status Classification between anesthesiologists and surgeons and its correlation with adverse patient outcomes.Scientific reports · 2022Article
- Estimated glomerular filtration rate and postoperative mortality in patients undergoing non-cardiac and non-neuron surgery: a single-center retrospective study.BMC surgery · 2021Article
- Surgical Apgar score is strongly associated with postoperative ICU admission.Scientific reports · 2021Article
- Developing a Simpler Prognosticating Tool: Comparing the Combined Assessment of Risk Encountered in Surgery Score with Deyo-Charlson Comorbidity Index and The American Society of Anesthesiologists Physical Status Score in Predicting 2 years Mortality after Hip Fracture Surgery.Geriatric orthopaedic surgery & rehabilitation · 2021Article
- Real-world results of the implementation of preoperative anaemia clinic with intravenous iron therapy for treating iron-deficiency anaemia: a propensity-matched case-control study.Annals of translational medicine · 2021Article
- Utilizing Machine Learning Methods for Preoperative Prediction of Postsurgical Mortality and Intensive Care Unit Admission.Annals of surgery · 2020Article
- Developing and validating subjective and objective risk-assessment measures for predicting mortality after major surgery: An international prospective cohort study.PLoS medicine · 2020Observational
- Anemia and perioperative mortality in non-cardiac surgery patients: a secondary analysis based on a single-center retrospective study.BMC anesthesiology · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAccurate surgical risk prediction is paramount in clinical shared decision making. Existing risk calculators have limited value in local practice due to lack of validation, complexities and inclusion of non-routine variables.
objectiveWe aim to develop a simple, locally derived and validated surgical risk calculator predicting 30-day postsurgical mortality and need for intensive care unit (ICU) stay (>24 hours) based on routinely collected preoperative variables. We postulate that accuracy of a clinical history-based scoring tool could be improved by including readily available investigations, such as haemoglobin level and red cell distribution width. METHODOLOGY: Electronic medical records of 90 785 patients, who underwent non-cardiac and non-neuro surgery between 1 January 2012 and 31 October 2016 in Singapore General Hospital, were retrospectively analysed. Patient demographics, comorbidities, laboratory results, surgical priority and surgical risk were collected. Outcome measures were death within 30 days after surgery and ICU admission. After excluding patients with missing data, the final data set consisted of 79 914 cases, which was divided randomly into derivation (70%) and validation cohort (30%). Multivariable logistic regression analysis was used to construct a single model predicting both outcomes using Odds Ratio (OR) of the risk variables. The ORs were then assigned ranks, which were subsequently used to construct the calculator.
resultsObserved mortality was 0.6%. The Combined Assessment of Risk Encountered in Surgery (CARES) surgical risk calculator, consisting of nine variables, was constructed. The area under the receiver operating curve (AUROC) in the derivation and validation cohorts for mortality were 0.934 (0.917-0.950) and 0.934 (0.912-0.956), respectively, while the AUROC for ICU admission was 0.863 (0.848-0.878) and 0.837 (0.808-0.868), respectively. CARES also performed better than the American Society of Anaesthesiologists-Physical Status classification in terms of AUROC comparison.
conclusionThe development of the CARES surgical risk calculator allows for a simplified yet accurate prediction of both postoperative mortality and need for ICU admission after surgery.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.