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This study aims to develop and validate a simple, accurate model to predict mortality after non-cardiac surgery.
This retrospective multi-center cohort study aimed to develop and externally validate a predictive model for postoperative mortality in adult patients undergoing non-cardiac surgery. The development cohort included patients from Asan Medical Center, and validation was performed using data from Seoul National University Hospital and Samsung Medical Center. Mortality was assessed at 30 days, 180 days, 1 year, and overall follow-up. The model was developed using LASSO logistic regression and evaluated for discrimination and calibration across cohorts.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Development Cohort | Patients undergoing non-cardiac surgery at Asan Medical Center. This cohort was used to develop the model. |
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| Validation Cohort 1 | Patients undergoing non-cardiac surgery at Seoul National University Hospital. This cohort was used for external validation. |
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| Validation Cohort 2 | Patients undergoing non-cardiac surgery at Samsung Medical Center. This cohort was also used for external validation. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| No Intervention: Observational Cohort | Other | Participants underwent non-cardiac surgery and were followed retrospectively without any experimental intervention. Data were collected from electronic medical records and national death registry to assess postoperative mortality outcomes. |
| Measure | Description | Time Frame |
|---|---|---|
| 30-day postoperative mortality | Death from any cause occurring within 30 days after non-cardiac surgery, ascertained from hospital records and national death registry data. | Up to 30 days after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| 180-day postoperative mortality | Death from any cause within 180 days after non-cardiac surgery. | Up to 180 days after surgery |
| 1-year postoperative mortality | Death from any cause within 365 days after non-cardiac surgery. |
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Inclusion Criteria:
Exclusion Criteria:
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Adult patients undergoing non-cardiac surgery at three tertiary hospitals in South Korea (Asan Medical Center, Seoul National University Hospital, and Samsung Medical Center). Patients with preoperative severe renal dysfunction, kidney transplantation, or missing key variables were excluded. A total of 642,377 patients were included for model development and validation.
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| Name | Affiliation | Role |
|---|---|---|
| Ji-Hoon Sim, MD, PhD | Asan Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Asan Medical Center, University of Ulsan College of Medicine | Seoul | 05505 | South Korea |
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| Up to 1 year after surgery |
| Overall postoperative mortality | Death from any cause during the entire follow-up period after non-cardiac surgery. | Through study completion (median follow-up: approximately 5 years, maximum: 13 years) |