ArticleFrontiers in surgery2026
A novel nomogram for predicting early postoperative cerebral desaturation events after congenital heart surgery.
Article in Frontiers in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
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Corrections and comments
- Erratum issued
Authors and funding
7 authors.
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Abstract
Background: Infants undergoing congenital heart surgery with cardiopulmonary bypass (CPB) are at high risk for perioperative neurological injury, and early postoperative cerebral desaturation events (CDEs) remain common. Reliable tools for individualized risk stratification are lacking. This study aims to develop and internally validate a nomogram for predicting early postoperative CDEs in infants undergoing congenital heart surgery with CPB. Methods: This retrospective cohort study included 397 infants aged >1 month and ≤1 year who underwent elective congenital heart surgery with CPB. Patients were randomly divided into a development cohort ( Results: Early postoperative CDEs occurred in 16.88% of the overall cohort, with comparable incidences in the development (18.1%) and validation (14.2%) cohorts. The final model included body surface area, RACHS-1 category, CPB duration, hematocrit during CPB, and CPB temperature strategy. The nomogram demonstrated good discrimination in the development cohort [C-statistic 0.798, 95% confidence interval (CI) 0.729-0.857] and the validation cohort (0.767, 95% CI 0.629-0.886), with satisfactory calibration. The decision curve analysis suggested potential clinical usefulness across clinically relevant threshold probabilities. Conclusions: An internally validated, infant-specific nomogram based on routinely available perioperative variables was developed to predict early postoperative cerebral desaturation following congenital heart surgery with CPB. External validation is required before clinical implementation.
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