A Surgical Apgar Score ≤4 was associated with a higher rate of major postoperative complications compared to a score of 9-10 (56.3% vs 5.0%; RR 11.3; 95% CI 8.6-14.8; P<.001).
Cohort (n=4,119)
No
Does the Surgical Apgar Score predict major postoperative complications and/or death within 30 days in general and vascular surgery patients?
The Surgical Apgar Score effectively identifies patients at high risk of major complications or death within 30 days after general and vascular surgery.
Effect estimate: RR 11.3 (95% CI 8.6-14.8)
Absolute Event Rate: 56.3% vs 5%
p-value: p=<.001
OBJECTIVES: To confirm the utility of a 10-point Surgical Apgar Score to rate surgical outcomes in a large cohort of patients. DESIGN: Using electronic intraoperative records, we calculated Surgical Apgar Scores during a period of 2 years (July 1, 2003, through June 30, 2005). SETTING: Major academic medical center. PATIENTS: Systematic sample of 4119 general and vascular surgery patients enrolled in the National Surgical Quality Improvement Program surgical outcomes database at a major academic medical center. MAIN OUTCOME MEASURES: Incidence of major postoperative complications and/or death within 30 days of surgery. RESULTS: Of 1441 patients with scores of 9 to 10, 72 (5.0%) developed major complications within 30 days, including 2 deaths (0.1%). By comparison, among 128 patients with scores of 4 or less, 72 developed major complications (56.3%; relative risk, 11.3; 95% confidence interval, 8.6-14.8; P < .001), of whom 25 died (19.5%; relative risk, 140.7; 95% confidence interval, 33.7-587.4; P < .001). The 3-variable score achieves C statistics of 0.73 for major complications and 0.81 for deaths. CONCLUSIONS: The Surgical Apgar Score provides a simple, immediate, objective means of measuring and communicating patient outcomes in surgery, using data routinely available in any setting. The score can be effective in identifying patients at higher- and lower-than-average likelihood of major complications and/or death after surgery and may be useful for evaluating interventions to prevent poor outcomes.
Scott E. Regenbogen (Mon,) conducted a cohort in General and vascular surgery (n=4,119). Surgical Apgar Score ≤4 vs. Surgical Apgar Score 9 to 10 was evaluated on Major postoperative complications within 30 days of surgery (RR 11.3, 95% CI 8.6-14.8, p=<.001). A Surgical Apgar Score ≤4 was associated with a higher rate of major postoperative complications compared to a score of 9-10 (56.3% vs 5.0%; RR 11.3; 95% CI 8.6-14.8; P<.001).