Evidence map›Paper›PMID 41215600›Full record

ArticleEuropean journal of anaesthesiology2026

Preoperative Endothelial Activation and Stress Index as a predictor of in-hospital mortality and postoperative complications in cardiac surgery with cardiopulmonary bypass: A retrospective cohort study.

Patrick Rehn, Ioannis Tsoukakis, Peter Full, Maik von der Forst, Benjamin Niehaus, Dania Fischer, Felix C F Schmitt, Matthias Karck, Markus Alexander Weigand, Christoph Lichtenstern and 3 more

Abstract read
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Article in European journal of anaesthesiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

13 authors.

Patrick RehnFrom the Department of Anaesthesiology, Heidelberg University Hospital, Heidelberg, Germany (PR, PF, MvdF, BN, DF, FCFS, AW, CL, MD), Department of Internal Medicine V, Hematology, Oncology and Rheumatology, Heidelberg University Hospital, Heidelberg, Germany (IT, TL), Institute of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany (MK, RA).
Ioannis Tsoukakis
Peter Full
Maik von der Forst
Benjamin Niehaus
Dania Fischer
Felix C F Schmitt
Matthias Karck
Markus Alexander Weigand
Christoph Lichtenstern
Thomas Luft
Rawa Arif
Maximilian DietrichORCID 0009-0001-2559-8390

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients undergoing cardiac surgery with cardiopulmonary bypass (CPB) are at risk for peri-operative complications, often linked to endothelial dysfunction. The Endothelial Activation and Stress Index (EASIX) has shown potential in predicting outcomes in various patient cohorts.

objectivesWe aimed to assess the prognostic value of EASIX for in-hospital mortality and postoperative outcomes in cardiac surgery patients with CPB.

designA retrospective cohort study.

settingA review of patients undergoing cardiac surgery with CPB at University Hospital Heidelberg from 2015 to 2023. PATIENTS: A total of 9642 patients were considered. After applying the exclusion criteria, 7233 patients with available preoperative levels of creatinine, lactate dehydrogenase, and platelet counts for EASIX calculation were included. The cohort was divided into a training group ( n  = 4446, until December 2019) and validation group ( n  = 2787, from January 2020).

main outcome measuresThe primary endpoint was in-hospital mortality, with secondary outcomes including ventilator days, ICU stay, and postoperative bleeding. Multivariate logistic regression was performed and ROC curve analyses were used to assess model performance and the added predictive value of EASIX.

resultsEASIX predicted in-hospital mortality in the training cohort [odds ratio (OR) per log 2 increase 2.08, P  < 0.001]. In the validation cohort, adding EASIX to the model significantly increased the AUC from 0.74 to 0.78 ( P  = 0.012). EASIX >2.32 is associated with an OR for mortality of 9.37 in the training, and for 4.47 in the validation cohort. Patients with EASIX >2.32 had significantly more ICU and ventilator days ( P  < 0.001) and higher risk of postoperative bleeding.

conclusionPreoperative EASIX is a validated, cost-effective tool for predicting in-hospital mortality and postoperative bleeding in patients undergoing cardiac surgery with CPB. It may enhance risk stratification and guide peri-operative management in high-risk patients.

Indexed as

Cardiac Surgical ProceduresCardiopulmonary BypassHospital MortalityPostoperative ComplicationsAgedFemaleHumansMaleMiddle AgedPredictive Value of TestsPrognosisRetrospective StudiesRisk AssessmentRisk Factors

Identifiers

PMID41215600
PMCPMC13152072

What Socratic holds

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