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Open research questions in Cardiac, Anesthesia and Surgical Outcomes

89 unresolved questions extracted from the limitations and future-work sections of 568 Cardiac, Anesthesia and Surgical Outcomes papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Absence of a comparator, - Observational nature of the available evidence, - Small sample size, - Retrospective derivation, - Lack of external validation, - Limited clinical deployment

    Editorial: Perioperative management and clinical challenges in elderly major surgical patients · 2026 · DOI

  • Further studies on the effectiveness of transcatheter aortic valve replacement, - Investigation of age-related variation in anesthetic sensitivity and cardiovascular reserve, - Development of preoperative prediction models for postoperative complications

    Editorial: Perioperative management and clinical challenges in elderly major surgical patients · 2026 · DOI

  • The model incorporates 33 preoperative predictors and has not been evaluated in a temporally distinct cohort.

    Temporal Validation and Simplification of Mortality Prediction for Perioperative Cardiopulmonary Resuscitation · 2026 · DOI

  • SUMMARY BACKGROUND DATA: Decisions about perioperative management of do-not-resuscitate (DNR) orders are common, yet their relationship to early postoperative outcomes remains poorly understood.

    Perioperative Continuation of Code-status Limitations and Early Postoperative Mortality · 2026 · DOI

  • Future research should focus on external validation, incorporation of economic variables, and finer-grained cost component analysis to further refine the model’s applicability and robustness.

    Using gradient boosting regression trees to identify cost drivers of laparoscopic surgery in elderly patients · 2025 · DOI

  • While various screening tools exist to assess physical, nutritional, and psychological status, there is currently no standardised self-reporting tool, or established cut-off points for comprehensive risk assessment.

    An Online Preoperative Screening Tool to Optimize Care for Patients Undergoing Cancer Surgery: A Mixed-Method Study Protocol · 2025 · DOI

  • As secondary AHF has been largely overlooked by medical research and education, little is known about its pathophysiology, phenotypes, diagnosis, management, and prognosis.

    Acute heart failure in non-cardiac surgery · 2025 · DOI

  • It remains unclear whether involvement of cardiologists in the management of patients developing PMI improves outcomes.

    Peri-operative myocardial infarction/injury after non-cardiac surgery: association between cardiologist evaluation and outcomes · 2025 · DOI

  • for the use of glucose and/or lipid-lowering medications, are provided on assessed risk,4 these recommendations using risk scores mostly rely on the estimated number needed to treat but have not been evaluated prospectively.

    iCARE4CVD: an innovative European consortium aiming to improve personalized cardiovascular care · 2025 · DOI

  • While effective for some, this approach does not account for the complex interplay of biological, environmental, and lifestyle factors unique to each patient.

    iCARE4CVD: an innovative European consortium aiming to improve personalized cardiovascular care · 2025 · DOI

  • Its performance in a European clinical setting and against high-sensitivity cardiac troponin (hs-cTnT), recommended by the latest European Society of Cardiology guidelines for pre-operative risk assessment in patients undergoing non-cardiac surgery, remains unknown.

    External validation of the PreOpNet deep learning algorithm for the prognosis of 30 days death and MACE: a European cohort · 2025 · DOI

  • However, its prognostic role in postoperative outcomes after coronary artery bypass grafting has not been fully elucidated.

    Long‐Term Prognostic Value of the Prognostic Nutritional Index in Patients Undergoing Coronary Artery Bypass Grafting · 2025 · DOI

  • Surveillance of patients at higher risk of cardiovascular complications is warranted and can lead to early recognition, closer monitoring, and appropriate management.

    Perioperative myocardial injury and infarction after noncardiac surgery: a review of pathophysiology, diagnosis, and management · 2024 · DOI

  • However, few studies have examined the relationship between laparoscopic surgery and physical functional decline.

    Laparoscopy for emergency abdominal surgery is associated with reduced physical functional decline in older patients: a cohort study · 2024 · DOI

  • However, it remains to be elucidated whether SII could have predictive value in patients with acute decompensated heart failure with preserved ejection fraction (ADHF-HFpEF).

    Prognostic impact of systemic immune-inflammation index in patients with acute decompensated heart failure with preserved ejection fraction -PURSUIT-HFpEF Registry- · 2024 · DOI

  • Future research is warranted, since strategies to reduce precipitating factors for POD may have a significant impact on post-TAVI outcomes.

    Predisposing and precipitating factors of post-operative delirium after transfemoral TAVI · 2024 · DOI

  • Abstract Background population aging has led to an increased burden of frailty as an emerging global health issue, and variables for its quantification in patients with infective endocarditis (IE) are lacking in current surgical risks scores.

    The 5-Item Modified Frailty Index (mFI-5) for risk stratification of patients with infective endocarditis undergoing cardiac surgery · 2024 · DOI

  • BACKGROUND: Functional capacity is critical to preoperative risk assessment, yet guidance on its measurement in clinical practice remains lacking.

    Clinical Tools to Assess Functional Capacity During Risk Assessment Before Elective Noncardiac Surgery · 2024 · DOI

  • Several tools lacked evidence on reliability (test consistency across similar measurements), pragmatic qualities (feasibility of implementation), or concurrent criterion validity (correlation to gold standard).

    Clinical Tools to Assess Functional Capacity During Risk Assessment Before Elective Noncardiac Surgery · 2024 · DOI

  • The role of echocardiographic diastolic parameters in predicting adverse outcomes after hip fracture surgery is not well established. Prior studies have identified various predictors of adverse outcomes, but the association between abnormal echocardiographic diastolic parameters and postoperative MACE and mortality is not well understood.

    Association of abnormal echocardiographic diastolic parameters and postoperative major adverse cardiac events and mortality in patients undergoing hip fracture surgery: a retrospective cohort study · 2026 · DOI

  • Several limitations should be acknowledged. First, the sin- gle-center design, relatively small sample size, and limited number of events may restrict generalizability and model stability. Larger multicenter prospective studies are required for validation. For the same reason, advanced model evalu- ation methods such as decision curve analysis were not performed, as estimates may be unreliable in small datas- ets. Second, potential selection bias should be considered. Patients with contraindications to iodinated contrast (e.g., prior hypersensitivity or advanced chronic kidney disease) were excluded from CCTA, limiting applicability to this high-risk subgroup. In addition, preoperative CCTA and biomarker results may have influenced subsequent manage- ment, including the implementation of preventive strategies. Third, measurement-related limitations exist. Variability in the timing of CCTA and laboratory assessments may have affected biomarker levels, and serial measurements of 1 3Association of thrombogenicity indices with perioperative cardiovascular events after non-cardiac surgery: a… thrombogenicity were not performed. Therefore, dynamic changes over time and their potential impact on postop- erative cardiovascular risk could not be evaluated. Finally, outcome-related considerations should be noted. The inclu- sion of MINS may have increased event rates by captur- ing biomarker-defined, often subclinical events. Moreover, given the limited number of events and the lack of system- atic classification of MI subtypes, further stratified analyses were not feasible.

    Association of thrombogenicity indices with perioperative cardiovascular events after non-cardiac surgery: a prespecified analysis of the PANDA study · 2026 · DOI

  • Investigation of the clinical impact of intranasal dexmedetomidine, - Definition of dosing regimens, - Clinical relevance of perioperative glycocalyx degradation

    Pediatric Anesthesia: Excellence in Patient Care · 2026 · DOI

  • The need for standardized sedation protocols in pediatric dentistry. The challenge of systematic reviews and meta-analyses in pediatric anesthesia due to heterogeneity and the overall quality of underlying publications.

    Pediatric Anesthesia: Excellence in Patient Care · 2026 · DOI

  • BackgroundPost-operative hypotension and vasoplegia are well recognised following cardiac surgery but remain poorly characterised after major non-cardiac surgery, despite associations with acute kidney injury (AKI), cardiovascular complications, and increased mortality.

    Peri Operative deLta rEnin ConcentrATion (POLECAT) Study Protocol and Analysis Plan · 2026 · DOI

  • The current pre-operative order sets may contribute to prolonged PACU stays. There is a need to identify and address contributing factors to prolonged PACU stays.

    Modification of pre-operative order set to reduce PACU stay times for outpatient benign gynecological surgery · 2026 · DOI

Most-cited papers in Cardiac, Anesthesia and Surgical Outcomes

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89 open questions have been extracted from the limitations and future-work passages of 568 Cardiac, Anesthesia and Surgical Outcomes papers in our 4.5M-paper local library. Each one below links back to the study that raised it, so you can read the original claim in context.

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