Risk Stratification and Long-Term Outcomes after Cardiac Surgery

Dear Colleagues,

Risk stratification plays an important role in cardiac surgery, where multivariable models are used to assess the clinical outcomes in an objective risk-adjusted manner. The Society of Thoracic Surgeons Adult Cardiac Surgery Risk Calculator in the United States and the European System for Cardiac Operative Risk Evaluation in Europe are two reliable, widely established and validated models for risk stratification in cardiac surgery.

In-hospital stay is the target period for most predictive models, and most cardiac surgery registries monitor patients only to the point of discharge from the hospital. However, it is widely known that in-hospital adverse events represent only one aspect of the periprocedural outcome. The early post-discharge period (first months after discharge up to one year postoperatively) represents a very important time interval because adverse events and complications directly related to the surgical procedure may also occur during this period. Furthermore, the mid-term period (up to 5 years) could be an ideal time interval to extract conclusive and safe results for the outcome of a surgical procedure. Finally, long-term follow-up (10 years or more) is needed in some cases to determine the efficacy of the surgical procedure, and to compare the outcome with the general population.

The aim of the present Special issue is to further the development and validation of risk stratification models for the prediction of long-term outcomes after cardiac surgery. Such predictive models will assist clinicians and surgeons in objective decision making for the benefit of our patients following the Hippocratic oath: “either help or do not harm the patient”.

Dr. Ioannis K. Toumpoulis
Guest Editor

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• risk stratification
• coronary artery bypass grafting
• cardiac surgery
• long-term outcome
• Kaplan-Meier survival curves
• multivariate Cox regression analysis
• preoperative/intraoperative/postoperative predictors
• time-varying effect