Validation of the Surgical Apgar Score in a Veteran Population Undergoing General Surgery

Melis, Marcovalerio; Pinna, Antonio; Okochi, Shunpei; Masi, Antonio; Rosman, Alan S.; Neihaus, Dena; Saunders, John K.; Newman, Elliot; Gouge, Thomas H.

doi:10.1016/j.jamcollsurg.2013.10.021

Cited by 24 publications

(9 citation statements)

References 11 publications

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“…There was no significant difference in the baseline characteristics of the patients who did and did not develop complications. This finding was similar to the ones reported previously (4,15) where comorbidities did not affect the 30-day mortality and morbidity.…”

Section: Discussionsupporting

confidence: 92%

“…SAS can determine need for monitoring and is especially beneficial in deciding shifting the patient to the intensive care unit (ICU) in a set up with limited resources and paucity of facilities. Melis et al have validated the score in a retrospective cohort of 2125 patients having undergone general surgical procedures including cancer surgeries, and overall mortality and 30-day morbidity has been found to be inversely proportional to SAS (4). The authors have also found a low SAS score to be strong predictor of ICU need.…”

Section: Introductionmentioning

confidence: 99%

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The utility of surgical Apgar score in predicting postoperative morbidity and mortality in general surgery

et al. 2022

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Objective: Many surgical scoring systems are used to predict operative risk but most are complicated. The aim of the study was to determine the utility of the Surgical Apgar Score (SAS) in predicting post operative mortality and morbidity in general surgical cases. Material and Methods: This was a prospective observational study. All adult patients for emergency and elective general surgical procedures were included. Intraoperative data was collected, and post operative outcomes were followed up till 30 days. SAS was calculated from intraoperative lowest heart rate, lowest MAP and blood loss. Results: A total of 220 patients were included in the study. All consecutive general surgical procedures were included. Sixty of the 220 cases were emergency and the rest were elective. Forty-five (20.5%) of the patients developed complication. Mortality rate was 3.2% (7 out of 220). The cases were divided into high risk (0-4), moderate risk (5-8) and low risk (9-10) based on SAS. Complication and mortality rates were 50% and 8.3% in the high risk group, 23% and 3.7% in the moderate risk and 4.2% and 0 in the low risk group, respectively. Conclusion: The surgical Apgar score is a simple and valid predictor of postoperative morbidity and 30-day mortality among patients undergoing general surgeries. It is applicable to all types of surgeries for emergency and elective cases and irrespective of the patient general condition and type of anesthesia and surgery planned.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

The utility of surgical Apgar score in predicting postoperative morbidity and mortality in general surgery

et al. 2022

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“…However, it has been reported that the SAS correlates with a patient's preoperative status, such as pre-existing comorbidities and operative complexity, and can therefore, effectively identify patients with a high risk of postoperative complication [22].…”

Section: Discussionmentioning

confidence: 99%

The relationship between the surgical Apgar score and postoperative complications in patients admitted to an intensive care unit after surgery

et al. 2019

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Background: Surgical Apgar score (SAS) is a 10-point system that measures estimated blood loss, lowest heart rate and lowest mean blood pressure during surgery, and is known to be associated with postoperative complications. The purpose of this study was to evaluate the relationship between SAS and postoperative major complications in patient admitted to intensive care unit (ICU) after surgery.Methods: We retrospectively reviewed 543 patients who were admitted to the ICU for 8 months. SAS, patient's demographics and postoperative outcomes were collected and analyzed based on anesthetic record and several medical records in an electronic chart system built in hospital. The patients were divided into three groups based on their SAS. The postoperative major complications, duration of ICU stay and duration of hospital stay were compared among the three groups.Results: In the low score group, the rate emergency, trauma and hepatobiliary operation were high. In this group, the duration of ICU and hospital stay, use of mechanical ventilation and inotropic in ICU, and postoperative complication were also increased. SAS also had a weak negative correlation with ICU stay and hospital stay. Postoperative complication and mortality rate doubled when compared to reference group (SAS 7-10) according to univariate logistic regression. Conclusions:In patients admitted to ICU after surgery, SAS, which can be measured during surgery, is closely related to postoperative parameters including major complications, mortality, and ICU stay. In other words, it is thought that the postoperative outcomes can be improved through appropriate monitoring and intervention for patients with low SAS score.

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“…The original SAS was developed in general surgery patients and has been validated in numerous populations of general and vascular surgical patients . Despite variations of patient characteristics in the different studies the SAS has overall demonstrated a good predictive ability for identifying patients at risk of major complications.…”

Section: Discussionmentioning

confidence: 99%

“…The predictive ability of the SAS after non‐specified vascular and general surgical procedures has been validated in different patient populations both in the Unites States and worldwide . A low SAS has been associated with a significantly increased risk of major complications within 30 days after surgery.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the surgical apgar score in patients undergoing Ivor–Lewis esophagectomy

Stroyer

Mantoni

Svendsen

2017

Journal of Surgical Oncology

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Background The Surgical Apgar Score is a simple outcome score based on intraoperative parameters. The scoring system is recently validated in patients undergoing esophagectomy but without comparable results. This study evaluated the ability of the original and modified Surgical Apgar Scores to predict major complications in a patient population undergoing Ivor–Lewis esophagectomy. Methods We retrospectively examined 234 patients who successfully underwent Ivor–Lewis esophagectomy at Rigshospitalet, Copenhagen from November 23, 2011 till November 23, 2014. Major complications were defined as Clavien–Dindo grade IIIa or higher within 30 days after surgery. Univariate and multivariate analyses were performed to assess factors associated with major complications. Receiver operating characteristics were performed for determination of the predictive value of the Surgical Apgar Score scoring systems. Results There were 64 (27.4%) patients with at least one major complication and 4 (1.7%) deaths. The original and modified versions of the Surgical Apgar Score were not associated with major complications and the scoring systems showed no significant predictive value when receiver operating characteristics were performed. Conclusions The original or modified versions of the Surgical Apgar Score could possibly be useful in some subgroups of esophagectomy patients, but should not be considered to have a general predictive value. J. Surg. Oncol. 2017;115:186–191. © 2017 Wiley Periodicals, Inc.

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Validation of the Surgical Apgar Score in a Veteran Population Undergoing General Surgery

Cited by 24 publications

References 11 publications

The utility of surgical Apgar score in predicting postoperative morbidity and mortality in general surgery

The utility of surgical Apgar score in predicting postoperative morbidity and mortality in general surgery

The relationship between the surgical Apgar score and postoperative complications in patients admitted to an intensive care unit after surgery

Evaluation of the surgical apgar score in patients undergoing Ivor–Lewis esophagectomy

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