Surgical Apgar Score in Hepatobiliopancreatic Surgery and Liver Transplantation — An Integrative Review

Abstract

The Apgar score was created to assess newborns’ risk of death and complications. The surgical Apgar score (SAS) was created to adapt this index to determine mortality and postsurgical morbidity. This scale ranges from 0 to 10, with the highest value corresponding to the patient with the lowest risk. Its use may be more widely disseminated to avoid and evaluate possible postoperative complications in specific surgeries. Objectives: This study aims to investigate the effectiveness of the SAS and its implication in postsurgical risk assessment in patients undergoing hepatobiliopancreatic surgery and hepatic transplantation. Methods: Integrative literature review developed through searches in the PubMed database. To compose this review, six articles were selected after analyzing and applying the criteria defined by the authors. Results: The use of the SAS has good statistical evidence as a scale for assessing the risk of complications and death in the postoperative period of hepatobiliopancreatic surgeries and hepatic transplantation. In addition to proving valuable and efficient in pancreatic surgeries, the SAS was also considered helpful in indicating complications after hepatic surgery and hepatic transplantation. Conclusion: The SAS can be clinically useful to guide decisions on rapid post-transplant and perioperative risk screening for general surgeries or the allocation of intensive care, given that it proves to be efficient as a strategy that can predict the chance of morbidity and mortality of a particular patient who underwent surgery.