INS and diabetes mellitus: A EuroSCORE II validation study by Barili et al. also suggested that diabetes on insulin is a significant risk factor for open surgical perioperative risk, while other factors, such as NYHA II, pulmonary and neuromuscular dysfunction as well as pulmonary artery systolic pressure < 55 mmHg, could be removed from the risk model without changing the performance of the model [21].