Key result
A high-risk Surgical Apgar Score (0-4) was associated with higher 30-day complication (50% vs 4.2%) and mortality rates (8.3% vs 0%) compared to a low-risk score (9-10).
Why the study?
Many surgical scoring systems used to predict operative risk are complicated, prompting evaluation of the simpler Surgical Apgar Score for predicting postoperative morbidity and mortality in general surgery.
Does the Surgical Apgar Score predict postoperative morbidity and 30-day mortality in adult patients undergoing general surgery?
Observational (n=220)
Does the Surgical Apgar Score predict postoperative morbidity and 30-day mortality in adult patients undergoing general surgery?
Absolute Event Rate: 50% vs 4.2%
The Surgical Apgar Score is a simple and valid tool for predicting 30-day postoperative morbidity and mortality in general surgery patients.
May support SAS for intraoperative risk stratification in general surgery; leaves open need for larger prospective validation before routine use.
Objectives: 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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Choudhari et al. (2022) conducted an observational in general surgical procedures (n=220). Surgical Apgar Score (SAS) vs. Low risk SAS (9-10) was evaluated on postoperative complications. A high-risk Surgical Apgar Score (0-4) was associated with higher 30-day complication (50% vs 4.2%) and mortality rates (8.3% vs 0%) compared to a low-risk score (9-10).
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