Surgical Apgar Outcome Score: Perioperative Risk Assessment for Radical Cystectomy

Prasad, Sandip M.; Ferreria, Marcos; Berry, Alexander; Lipsitz, Stuart R.; Richie, Jerome P.; Gawande, Atul A.; Hu, Jim C.

doi:10.1016/j.juro.2008.10.165

Cited by 77 publications

(52 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Ito et al [7] demonstrated that patients who underwent renal mass excision were 3.7 times more likely to experience a major complication when the SAS was lower than 4, and 24 times more likely to die within 90 days of surgery as compared to those with a SAS ≥ 8. In patients who underwent radical cystectomy Prasad et al [8] showed a progressive decrease in complications with increasing SAS. We sought to evaluate the practicability of the SAS to predict perioperative adverse events (PAE) of robot-assisted laparoscopic transperitoneal radical prostatectomy (RARP) and open retropubic radical prostatectomy (ORRP) within 30 days of surgery.…”

Section: Introductionmentioning

confidence: 97%

Association between the Surgical Apgar Score and Perioperative Complications after Radical Prostatectomy

Orberger

Palisaar²,

Roghmann³

et al. 2016

Urol Int

View full text Add to dashboard Cite

Objective: To evaluate whether the Surgical Apgar Score (SAS) can identify patients who are at risk for perioperative adverse events (PAE) following radical prostatectomy for prostate cancer. Patients and Methods: At a single academic institution, 994 patients undergoing radical prostatectomy between 2010 and 2013 were analyzed retrospectively. The SAS was calculated from anesthesia records, evaluated to predict PAE within a 30-day time period postoperatively; these events were classified according to standardized classification systems. Results: We observed adverse events in 45.4% (451/994) of patients with a total of 694 events. Overall, 41% (408/994) had low- and 9.9% (98/994) had high-grade events. A lower SAS was identified as an independent predictor of any (p < 0.001) and low-grade adverse events (p = 0.001) for those patients who had undergone open retropubic radical prostatectomy (ORRP). Each 1-point increment resulted in a 24% decrease in the odds of any (95% CI 0.66-0.88) and a 21% decrease in the odds of a low-grade (95% CI 0.69-0.91) event. Adverse events of robot-assisted prostatectomy were not associated with the SAS. Conclusions: Lower SAS values indicate patients at risk for adverse events after ORRP. The SAS might serve as one variable for outcome assessment, reflecting the challenge of mutual surgical and anesthesiology procedure management.

show abstract

Section: Introductionmentioning

confidence: 97%

Association between the Surgical Apgar Score and Perioperative Complications after Radical Prostatectomy

Orberger

Palisaar²,

Roghmann³

et al. 2016

Urol Int

View full text Add to dashboard Cite

show abstract

“…To date, Gawande's Surgical Apgar Score has been studied in colorectal surgery, vascular surgery, and certain gynecologic and urologic procedures. [7][8][9][10][11] The burgeoning literature on the Surgical Apgar Score also identifies potential weaknesses of the scoring system. For example, calculation of the score relies on EBL, which critics have often tagged as imprecise.…”

mentioning

confidence: 99%

Expansion of the Surgical Apgar Score across All Surgical Subspecialties as a Means to Predict Postoperative Mortality

et al. 2011

View full text Add to dashboard Cite

Background: A surgical scoring system, akin to the obstetrician's Apgar score, has been developed to assess postoperative risk. To date, evaluation of this scoring system has been limited to general and vascular services. The authors attempt to externally validate and expand the Surgical Apgar Score across a wide breadth of surgical subspecialties. Methods: Intraoperative data for 123,864 procedures including all surgical subspecialties were collected and associated with Surgical Apgar Scores (created by the summation of point values associated with the lowest mean arterial pressure, lowest heart rate, and estimated blood loss). Patients' death records were matched to the corresponding score, and logistic regression models were created in which mortality within 7, 30, and 90 days was regressed on the Apgar score. Results: Lower Surgical Apgar Scores were associated with an increased risk of death. The magnitude of this association varied by subspecialty. Some subspecialties exhibited higher odds ratios, suggesting that the score is not as useful for them. For most of the subspecialties the association between the Apgar score and mortality decreased as the time since surgery increased, suggesting that predictive ability ceases to be helpful over time. After

show abstract

“…Although this score has been validated in selected orthopaedic procedures (10,11,12,13,14) we also wanted to observe the utility of the SAS in the trauma hip fracture surgery patients. Hip fracture surgery repairs are operations of different magnitude.…”

Section: Discussionmentioning

confidence: 99%

Implementing the Surgical Apgar Score in patients with trauma hip fracture

Sakan

Pavlović

Milošević

et al. 2015

Injury

View full text Add to dashboard Cite

Surgical Apgar Outcome Score: Perioperative Risk Assessment for Radical Cystectomy

Cited by 77 publications

References 13 publications

Association between the Surgical Apgar Score and Perioperative Complications after Radical Prostatectomy

Association between the Surgical Apgar Score and Perioperative Complications after Radical Prostatectomy

Expansion of the Surgical Apgar Score across All Surgical Subspecialties as a Means to Predict Postoperative Mortality

Implementing the Surgical Apgar Score in patients with trauma hip fracture

Contact Info

Product

Resources

About