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NCT Number: NCT06770738

EuroSCORE-II and POSPOM in Cardiac Surgery

We aim to compare the performances of the European System for Cardiac Operative Risk Evaluation (EuroSCORE-II) and the PreOperative Score to Predict Postoperative Mortality (POSPOM) in predicting in-hospital mortality among patients undergoing on-pump cardiac surgery, with further evaluation of discrimination, calibration, agreement, and clinical utility.

This retrospective observational study will be conducted at a single tertiary university cardiac surgery centre. Adult patients (≥18 years) who underwent coronary artery bypass grafting, valve surgery, or combined procedures between 2020 and 2024 will be included. No experimental interventions will be applied. Preoperative EuroSCORE-II and POSPOM values will be calculated for all patients. Discrimination will be assessed using ROC and precision-recall curves with DeLong's test. Calibration will be evaluated using calibration-in-the-large, calibration slope, Hosmer-Lemeshow testing, and GiViTI calibration belts. Agreement will be analyzed using ICC, CCC, Bland-Altman plots, and Passing-Bablok and Deming regression. Subgroup analyses will be performed by age and sex.

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Key information

Conditions

Cardiac Disease Anesthesia Cardiovascular Complication Cardiovascular Diseases Heart Diseases Pathologic Processes Pathological Conditions, Signs and Symptoms Perioperative/Postoperative Complications Postoperative Complications Surgery

Age range

18 year–100 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Istanbul University- Cerrahpasa

Istanbul, Turkey (Türkiye)

About this study

Preoperative risk assessment is important in determining the treatment plans of patients who will undergo surgery, providing patient education for the postoperative period, providing insight into prognosis, and determining healthcare quality standards. The European System for Cardiac Operative Risk Evaluation-II (EuroSCORE-II) was developed specifically for patients in cardiac surgery. It is a scoring system widely used worldwide that predicts mortality through preoperative evaluation. New studies in the literature have reported that the sensitivity of EuroSCORE-II may be lower in older patients (over 70 and 80 years of age). A scoring system with higher predictive power is aimed by making modifications to EuroSCORE-II or by making comparisons with other scoring systems. PreOperative Score to Predict Post-Operative Mortality (POSPOM), defined by Le Manach et al. in 2016, is a useful scoring system that can be used for all types of surgery and can predict postoperative mortality through preoperative evaluation of patients. POSPOM includes parameters that evaluate the patient's age, the type of surgery to be performed, and the patient's comorbidities. It appears to be a useful scoring system because it is applicable to all types of surgery and provides information about patient mortality in a short time by collecting patient values in 3 main groups. There are various studies conducted on patients undergoing hip fractures, radical cystectomy, uro-oncological surgery, and non-cardiac vascular surgery. However, a review of the literature revealed an absence of studies investigating cardiac surgery patients alone.

The primary objective of this study was to investigate whether the POSPOM score has sufficient predictive power for in-hospital mortality in patients undergoing cardiac surgery. The secondary objective was to evaluate the correlation between POSPOM mortality predictions and EuroSCORE-II mortality predictions in patients undergoing cardiac surgery.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients aged 18 and over, patients who have CABG surgery, valve surgery or both, and patients with on-pump surgery will be included in the study.

Exclusion criteria

  • . Patients under the age of 18, patients with off-pump surgery, and patients with non-cardiac vascular surgery will be excluded from the study.

Treatment and study plan

There is no intervention in this study.

Other

This study is planned as a retrospective study. Only the information of the patients will be used.

Primary outcomes

  1. investigation whether the POSPOM score has sufficient predictive power for in-hospital mortality in patients undergoing cardiac surgery

    Time frame: 1 month

    The primary objective of this study was to investigate whether the POSPOM score has sufficient predictive power for in-hospital mortality in patients undergoing cardiac surgery.

    Measure Type: Continuous Unit of Measure: ROC-AUC

    Minimum: 0.50 Maximum: 1.00

    Description of Meaningful Outcome:

    Predictive performance will be considered clinically meaningful if the ROC-AUC of the POSPOM score for in-hospital mortality is significantly greater than 0.50.

Secondary outcomes

  1. Correlation of EuroSCORE-II and POSPOM

    Time frame: 15 days

    Evaluation of the correlation between POSPOM mortality predictions and EuroSCORE-II mortality predictions in patients undergoing cardiac surgery.

    Measure Type: Continuous Unit of Measure: Correlation coefficient (r)

    Minimum: -1.0 Maximum: +1.0

    Description of Meaningful Outcome:

    A statistically significant correlation coefficient (p < 0.05) will indicate agreement between POSPOM and EuroSCORE-II mortality predictions. A correlation coefficient of |r| ≥ 0.50 will be considered clinically meaningful.

Sponsors and collaborators

Lead sponsor

Istanbul University - Cerrahpasa

Other

Registry information

Official study title

Predictive Performance of EuroSCORE-II and POSPOM for Perioperative Mortality in Cardiac Surgery: A Retrospective Study

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Jan 13, 2025
Registry last updated
Dec 31, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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