Usefulness of the Surgical Apgar Score to Predict the Occurrence of Major Complications in the Early Post-Operative Period of Major Surgeries: Experience of Two Second-Category Hospitals in Cameroon

Abstract

Objective: The Surgical Apgar Score (SAS) is a tool for intraoperative stratification of the risk of serious complications in the early postoperative period. It varies from 0 to 10 points divided into three risk categories (0 to 4 high, 5 to 7 moderate, 8 to 10 low). The aim of the study was to evaluate its relevance in predicting the appearance of these complications. Material and methods: This descriptive and analytical study was carried out at the "Laquintinie" Hospital in Douala and at the Central Hospital in Yaounde, Cameroon. The main data were collected on a population of patients over 18 years old and recorded on a survey form. They consisted of variables of main interest and exposure variables. Univariate and multivariate statistical analysis using top-down logistic regression models made it possible to evaluate the association of each variable of main interest and each exposure variable. The association was significant at P < 0.05. The multivariate analysis assessed the strength of the link by concomitantly adjusting for the other exposure variables having a level of significance ≤0.25 in univariate, and in the final model those presenting a significance ≤0.05. The relation was significant at P < 0.05. Results: Of the 88 patients studied, the SAS was < 4 for 17, 5 -7 for 66. Univariately, the prevalence of complications was significantly higher in the category of SAS < 4; OR (CI) 0.1 (0.1 -0.2) as well as for Altemeier classes 3 and 4, ASA 3 and 4, the duration of the intervention > 3 hours. In multivariate, this link persisted only and strongly for the SAS OR (IC) 0.1 (0.1 -0.2) and p = 000. Conclusion: