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

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• 作者：Marcovalerio Melis ; Antonio Pinna ; Shunpei Okochi ; Antonio Masi ; Alan S. Rosman ; Dena Neihaus ; John K. Saunders ; Elliot Newman ; Thomas H. Gouge
• 刊名：Journal of the American College of Surgeons
• 出版年：February, 2014
• 年：2014
• 卷：218
• 期：2
• 页码：218-225
• 全文大小：752 K

文摘

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Background

The Surgical Apgar Score (SAS, a 10-point score calculated using limited intraoperative data) can correlate with postoperative morbidity and mortality after general surgery. We evaluated reliability of SAS in a veteran population.

Study Design

We prospectively collected demographics, medical history, type of surgery, and postoperative outcomes for any veteran undergoing general surgery at our institution (2006-2011). We categorized patients in 4 SAS groups and compared differences in morbidity and mortality.

Results

Our study population included 2,125 patients (SAS 鈮?: n聽= 29; SAS 5鈭?: n聽= 227; SAS 7鈭?: n聽= 797; SAS 9鈭?0: n聽= 1,072). Low-SAS patients were likely to have significant preoperative comorbidities and to undergo major surgery, and had increased postoperative morbidity and 30-day mortality.

Conclusions

The SAS is easily calculated from 3 routinely available intraoperative measurements, correlates with fixed preoperative risk (acute conditions, pre-existing comorbidities, operative complexity), and effectively identifies veterans at high risk for postoperative complications.