Prognostic Value of Preoperative Serum Endocan in Pediatric Congenital Heart Surgery: A Prospective Observational Study

Abstract Objectives This study aimed to evaluate the prognostic significance of serum endocan levels in pediatric patients undergoing congenital heart surgery with cardiopulmonary bypass (CPB). Methods This prospective observational study included 31 patients. Endocan levels were measured preoperatively, and postoperative day 1 and 6. Correlations between endocan levels, laboratory, clinical parameters were analyzed using Spearman’s rank correlation and receiver operating characteristic (ROC) analysis. Results Preoperative endocan levels were higher in patients with adverse outcomes, however it didn’t reach statistical significance. The ROC analysis demonstrated a moderate predictive capacity of preoperative endocan levels for mortality (AUC = 0.68). A statistically significant positive correlation was found between endocan and aspartate aminotransferase (AST) (r = 0.42, p = 0.020), while a significant negative correlation was observed with the neutrophil count (r = − 0.38, p = 0.034). No significant associations were identified with Aristotle scores or acute kidney injury (AKI). Preoperative endocan levels showed trends toward associations with adverse outcomes but lacked sufficient discriminative power. Discussion Endocan does not appear to be a reliable standalone predictor of postoperative risk. Further studies with larger samples and serial measurements are needed.