Prediction of Post-operative morbidity based on Surgical Apgar Score

Background: In today’s era cost of health care is of growing importance and it is important to rec-ognize patients at increased risk of post-operative morbidity and mortality and to find interventions to re-duce the risk. Hence, there is a need of an objective prognostic tool to assess the post-operative outcome of patients, than the subjective gut feeling of surgeons. The surgical Apgar score (SAS) is a simple score that uses intraoperative information on hemodynamics and blood loss of patient to predict post-operative mor-bidity and mortality. Score on a scale of 0-10 calculated from three parameters collected during the opera-tive procedure, lowest heart rate (HR), lowest mean arterial pressure (MAP), and estimated blood loss. Materials and Methods: It is an 18 months prospective study done in RL Jalappa Hospital, Kolar. Emergency and elective major cases were included in this study. SAS calculated based on intraoperative pa-rameters lowest MAP, lowest HR, and amount of blood loss. Results: A total of 100 patients studied, age ranged from 18 to 70 years. 71 elective and 29 emergency surgeries, the majority were gastrointestinal sur-geries. SAS was significantly associated with post-operative morbidity and mortality within 30 days (P < 0.001). Of 100 patients, 30 had SAS 4 or less. Complications noted in 23 out of 30 patients. By comparison among 5 patients with SAS 9 or 10 none experienced complications. Conclusion: SAS is a simple prognostic tool for assessing post-operative outcome in general surgical patients.