ACEF II Score — Cardiac Surgery Operative Mortality Risk

The ACEF II Score (Age, Creatinine, Ejection Fraction) is a simplified preoperative risk stratification tool for adult patients undergoing cardiac surgery, designed to predict 30-day/in-hospital operative mortality. The original ACEF score formula (Age/EF + 1 if Cr > 2 mg/dL) was updated to ACEF II by incorporating an emerging risk factor (history of cardiac surgery) and refining continuous creatinine integration. ACEF II is validated against EuroSCORE II and STS Score in multiple European cohorts, demonstrating comparable mortality discrimination for common cardiac surgeries (CABG, valve replacement/repair, combined procedures) with the advantage of rapid 3-variable bedside calculation.