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1  PARTICIPANTS
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  N = 296, IAPI = 25, incidence = 8.4% (Wilson 95% CI 5.8-12.2)
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2  TABLE 3  Scale scores by IAPI status (Welch t test)
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  CORN preoperative      11.04 +/- 1.695   vs  7.69 +/- 2.448   t =  9.049  P = <0.001
  CORN intraoperative    10.68 +/- 2.545   vs  5.31 +/- 1.823   t = 10.316  P = <0.001
  Munro preoperative      9.16 +/- 1.599   vs  8.21 +/- 1.724   t =  2.833  P = 0.008
  Munro intraoperative   25.16 +/- 2.410   vs 21.27 +/- 3.075   t =  7.520  P = <0.001
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3  TABLE 4  Risk grades by IAPI status (Mann-Whitney U)
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  CORN preoperative      IAPI  1/23/ 1  no-IAPI 192/ 74/  5  |Z| =  6.609  P = <0.001
  CORN intraoperative    IAPI  3/16/ 6  no-IAPI 246/ 24/  1  |Z| = 10.521  P = <0.001
  Munro preoperative     IAPI  1/24/ 0  no-IAPI  45/226/  0  |Z| =  1.662  P = 0.097
  Munro intraoperative   IAPI  0/11/14  no-IAPI   0/228/ 43  |Z| =  4.861  P = <0.001
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4  TABLES 5 & 6  ROC analysis
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  CORN preoperative      AUC = 0.862 (95% CI 0.816-0.908)  cut-off  8.5  sens 96.0%  spec 70.8%  J = 0.668
  CORN intraoperative    AUC = 0.948 (95% CI 0.914-0.982)  cut-off  7.5  sens 88.0%  spec 90.8%  J = 0.788
  Munro preoperative     AUC = 0.667 (95% CI 0.573-0.761)  cut-off  7.5  sens 92.0%  spec 39.1%  J = 0.311
  Munro intraoperative   AUC = 0.838 (95% CI 0.773-0.903)  cut-off 22.5  sens 92.0%  spec 67.5%  J = 0.595

  Paired comparison of AUCs (DeLong test):
   preoperative             diff = 0.195 (95% CI 0.112-0.277)  Z = 4.628  P = <0.001
   intraoperative           diff = 0.110 (95% CI 0.046-0.173)  Z = 3.394  P = <0.001
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5  OBSERVED IAPI INCIDENCE BY RISK GRADE (Table 7)
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  CORN preoperative:
     Low       n=193  IAPI  1    0.5% (95% CI 0.0-2.9)
     Moderate  n= 97  IAPI 23   23.7% (95% CI 15.7-33.4)
     High      n=  6  IAPI  1   16.7% (95% CI 0.4-64.1)
  CORN intraoperative:
     Low       n=249  IAPI  3    1.2% (95% CI 0.2-3.5)
     Moderate  n= 40  IAPI 16   40.0% (95% CI 24.9-56.7)
     High      n=  7  IAPI  6   85.7% (95% CI 42.1-99.6)
  Munro preoperative:
     Low       n= 46  IAPI  1    2.2% (95% CI 0.1-11.5)
     Moderate  n=250  IAPI 24    9.6% (95% CI 6.2-13.9)
     High      n=  0  --
  Munro intraoperative:
     Low       n=  0  --
     Moderate  n=239  IAPI 11    4.6% (95% CI 2.3-8.1)
     High      n= 57  IAPI 14   24.6% (95% CI 14.1-37.8)

  Note: neither scale publishes a score-to-probability mapping, so this is observed
  incidence by grade, not an assessment of probability calibration.
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6  INTERNAL CONSISTENCY (Cronbach's alpha)
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  CORN,  9 ordinal items (diabetes item excluded) : 0.738
  CORN, all 10 items                             : 0.685
  Munro, all 15 items                            : 0.676
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R version:  R version 4.5.1 (2025-06-13) 
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7  SENSITIVITY ANALYSES (Section 3.6 and Table 8)
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  Per-item AUC (Table 8):
    corn_pre_asa             0.725 (0.629-0.822)
    corn_pre_bmi             0.599 (0.487-0.711)
    corn_pre_skin            0.536 (0.482-0.591)
    corn_pre_mobility        0.537 (0.453-0.621)
    corn_pre_exp_time        0.893 (0.831-0.955)
    corn_pre_diabetes        0.479 (0.421-0.537)
    corn_int_temp            0.780 (0.709-0.850)
    corn_int_blood           0.825 (0.729-0.922)
    corn_int_shear           0.797 (0.709-0.884)
    corn_int_act_time        0.876 (0.796-0.956)
    munro_pre_mobility       0.621 (0.522-0.720)
    munro_pre_fasting        0.517 (0.506-0.527)
    munro_pre_bmi            0.595 (0.483-0.706)
    munro_pre_wtloss         0.623 (0.533-0.714)
    munro_pre_age            0.533 (0.418-0.648)
    munro_pre_comorb         0.553 (0.456-0.650)
    munro_int_asa            0.650 (0.576-0.725)
    munro_int_anesth         0.613 (0.569-0.657)
    munro_int_temp           0.802 (0.721-0.882)
    munro_int_bp             0.720 (0.671-0.769)
    munro_int_moisture       0.599 (0.514-0.684)
    munro_int_surface        0.799 (0.733-0.865)
    munro_int_position       0.507 (0.420-0.593)
    munro_post_ortime        0.840 (0.770-0.911)
    munro_post_blood         0.755 (0.651-0.859)

  Paired comparisons under alternative matchings:
    preoperative, as reported                      0.862 vs 0.667  diff +0.195 (0.112 to 0.277) P = 0.000
    preoperative, CORN without expected operative time 0.712 vs 0.667  diff +0.045 (-0.036 to 0.125) P = 0.279
    intraoperative, as reported                    0.948 vs 0.838  diff +0.110 (0.046 to 0.173) P = 0.001
    intraoperative, stage-matched                  0.948 vs 0.891  diff +0.057 (-0.003 to 0.117) P = 0.062
    intraoperative, duration-matched               0.948 vs 0.917  diff +0.031 (-0.016 to 0.077) P = 0.196
    whole scale vs Munro cumulative                0.941 vs 0.838  diff +0.103 (0.040 to 0.165) P = 0.001
    whole scale vs complete Munro                  0.941 vs 0.892  diff +0.049 (0.011 to 0.086) P = 0.012

  Accuracy with 95% CI at the reported cut-offs (Table 6):
    CORN preoperative      sens 96.0 (79.6-99.9)  spec 70.8 (65.0-76.2)  PPV 23.3 (15.5-32.7)  NPV 99.5 (97.1-100.0)
    Munro preoperative     sens 92.0 (74.0-99.0)  spec 39.1 (33.3-45.2)  PPV 12.2 (7.9-17.8)  NPV 98.1 (93.5-99.8)
    CORN intraoperative    sens 88.0 (68.8-97.5)  spec 90.8 (86.7-93.9)  PPV 46.8 (32.1-61.9)  NPV 98.8 (96.5-99.8)
    Munro intraoperative   sens 92.0 (74.0-99.0)  spec 67.5 (61.6-73.1)  PPV 20.7 (13.6-29.5)  NPV 98.9 (96.1-99.9)

  Munro at its own published high-risk boundary (cumulative >= 25):
    sensitivity 56.0 (34.9-75.6)   specificity 84.1 (79.2-88.3)

  Floor scores (proportion at the lowest possible value):
    munro_pre_wtloss         94.6% (280/296)
    munro_pre_mobility       85.8% (254/296)
    munro_int_temp           69.9% (207/296)
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TABLE 1  Characteristics by IAPI occurrence
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  n = 25 with IAPI, 271 without

  Age (years)  52.72 +/- 20.89  vs  49.57 +/- 15.81   Welch t = 0.734, df = 26.6, P = 0.469

  Sex                    Fisher's exact P = 0.000
    male                   21 (84.0)   103 (38.0)
    female                  4 (16.0)   168 (62.0)

  BMI (kg/m2)            Fisher's exact P = 0.162
    lt18.5                  3 (12.0)    12 ( 4.4)
    18.5-23.9              10 (40.0)   155 (57.2)
    24.0-27.9               9 (36.0)    79 (29.2)
    ge28                    3 (12.0)    25 ( 9.2)

  Surgical position      Fisher's exact P = 0.000
    supine                  9 (36.0)   168 (62.0)
    lithotomy               1 ( 4.0)    61 (22.5)
    prone                   9 (36.0)    26 ( 9.6)
    lateral                 6 (24.0)    16 ( 5.9)

  Admission type         Fisher's exact P = 1.000
    elective               21 (84.0)   230 (84.9)
    emergency               4 (16.0)    41 (15.1)

  ASA grade              Fisher's exact P = 0.000
    1                       1 ( 4.0)    64 (23.6)
    2                      11 (44.0)   162 (59.8)
    3                       9 (36.0)    40 (14.8)
    4                       4 (16.0)     5 ( 1.8)

  Anaesthesia            Fisher's exact P = 0.045
    general                24 (96.0)   200 (73.8)
    regional_or_block       1 ( 4.0)    43 (15.9)
    monitored_or_local      0 ( 0.0)    28 (10.3)

  Actual op. time (h)    Fisher's exact P = 0.000
    lt3                     4 (16.0)   233 (86.0)
    3-3.5                   1 ( 4.0)    11 ( 4.1)
    3.5-4                   0 ( 0.0)     8 ( 3.0)
    ge4                    20 (80.0)    19 ( 7.0)

  Comorbidities (n)      Fisher's exact P = 0.080
    0                      12 (48.0)   173 (63.8)
    1                      12 (48.0)    64 (23.6)
    2                       1 ( 4.0)    23 ( 8.5)
    3                       0 ( 0.0)    11 ( 4.1)

  Surgical specialty (no test; 14 categories with 25 events):
    orthopaedics             total  70 | IAPI  8 | no IAPI  62
    obstetrics_gynaecology   total  47 | IAPI  0 | no IAPI  47
    gastrointestinal         total  31 | IAPI  1 | no IAPI  30
    urology                  total  29 | IAPI  3 | no IAPI  26
    head_and_neck            total  22 | IAPI  3 | no IAPI  19
    neurosurgery             total  19 | IAPI  7 | no IAPI  12
    breast                   total  16 | IAPI  0 | no IAPI  16
    thyroid                  total  15 | IAPI  0 | no IAPI  15
    hepatobiliary            total  11 | IAPI  0 | no IAPI  11
    vascular                 total  10 | IAPI  0 | no IAPI  10
    cardiac_great_vessel     total   9 | IAPI  3 | no IAPI   6
    thoracic                 total   8 | IAPI  0 | no IAPI   8
    ophthalmology            total   5 | IAPI  0 | no IAPI   5
    plastic                  total   4 | IAPI  0 | no IAPI   4

  NOTE: age ranges 18-88 years; 0 participants were under 18.
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