This systematic review assesses clinical prediction models (CPMs) that incorporate intra-operative variables to predict outcomes following adult cardiac surgery. It highlights the identification of 24 CPMs, predominantly predicting acute kidney injury and peri-operative mortality, using common variables like cardiopulmonary bypass time. Despite acceptable discrimination in internally validated models, poor calibration and high bias risk limit their practical use. The review suggests potential improvement in model accuracy with intra-operative data, advocating for more robust studies.