Congenital heart diseaseDiagnostic or prognostic study
The PROMISE-ACHD Score
- development and validation of a surgical risk model
- registry
- 11 centers
- bootstrap resampling
- prespecified temporal and center-based validation cohorts
Authors' conclusion
The PROMISE-ACHD score is a practical model that predicts both mortality and major complications after complex ACHD surgery. Using contemporary clinical and imaging variables, it enables accurate risk stratification and may inform individualized surgical decision-making.
Study context
- Population
- Adults with congenital heart disease (ACHD) of moderate or great complexity who underwent open-heart surgery, 2013–2024
- Participants
- 1,002 registry patients
- Comparison
- The PROMISE-ACHD score vs the PErioperative ACHd score
- Outcome
- Composite of:
- In-hospital mortality
- Major perioperative complications defined by the Society of Thoracic Surgeons
Performance
As reported in the abstract
PROMISE-ACHD score
0.724
AUC · 95% CI 0.687–0.761
PErioperative ACHd score
0.658
AUC · 95% CI 0.616–0.700
P < 0.001
- integrated discrimination improvement
- 0.058
- PROMISE-ACHD score vs PErioperative ACHd score: AUC 0.724 (95% CI: 0.687-0.761) vs 0.658 (95% CI: 0.616-0.700); P <
- 0.001
Further findings
AUC
| Outcome | temporal validation cohort | center-based validation cohort |
|---|---|---|
| Discrimination in validation cohorts | 0.784 | 0.773 |
In-hospital mortality and major perioperative complications
- In-hospital mortality
- 2.6%
- Major perioperative complications
- 19.8%
Predictors of the primary endpoint
- Variables predicting the primary endpoint
- Nine
Discrimination in validation cohorts
- acceptable calibration and stepwise risk stratification
Original publication
The PROMISE-ACHD Score. JACC Adv. Published 6 July 2026. doi:10.1016/j.jacadv.2026.102975
Summarised from the published abstract; every number is checked against it