Predicting the future by looking at the past: necessary but not binding

This editorial refers to ‘The ACEF II risk score for cardiac surgery: updated but still parsimonious’, by M. Ranucci et al., doi: 10.1093/eurheartj/ehx228.

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In the complex field of cardiac surgery, risk stratification is important pre-operatively, to aid in a dispassionate prediction of outcome, and post-operatively, to allow adjustment for comparative audit. A good risk scoring system can help to put things in perspective for patients, healthcare providers, insurance companies, and, importantly, public opinion.¹ Ranging in complexity from simple risk scores to sophisticated prediction calculators, many risk stratification models have been proposed for cardiac surgery (Table 1).

Table 1

A summary of cardiac surgery risk-stratification models

Model	Region	Year of data collection	Year of publication	Number of patients (centres)	Risk variables
EuroSCORE6	Europe	1995...