Objectives To investigate the risk factors of 30-day mortality and postoperative pulmonary
complication in neonatal noncardiac surgery and to establish models for predicting the 30 d mortality. Methods Retrospective analysis of clinical data of newborns undergoing cardiac surgery in hospitals from September 2018 to
February 2022. Single factor and multivariate logistic regression analysis were used to determine the risk factors
associated with postoperative pulmonary complications and postoperative death. And construct a predictive model for
postoperative death within 30 days. survival,as well as constructthe prediction model of 30 d mortality. Results Of 140 patients,85(60.7%) experienced a postoperative pulmonary complication and 13(0.93%)died within 30 d
after surgery. Among all factors,cardiopulmonary bypass (P=0.002)and intraoperative use of albumin (P=0.038)were associated with PPC. Prematurity (P=0.01),emergency operation(P = 0.009)and surgery length (P = 0.001)
were significant contributors to 30 d mortality. According to these three risk factors ,a nomogram model was
constructed to predict the 30 d mortality after neonatal noncardiac surgery. The C-index value was 0.862(95% CI:
0.758 ~ 0.966),and the receiver operating characteristic curve and calibration curve showed that the nomogram
model had a moderate prediction ability. Conclusion The developed and validated nomogram can be used to
calculate the individualized risk of postoperative mortality and become a practical tool for anesthetist and clinicians
to achieve better treatment for high-risk newborn infants.