Melis, Marcovalerio and Pinna, Antonio <1963- > and Okochi, Shunpei and Masi, Antonio and Rosman, Alan Steven and Neihaus, Dena and Saunders, John K. and Newman, Elliot and Gouge, Thomas H. (2014) Validation of the surgical Apgar score in a veteran population undergoing general surgery. Journal of the American College of Surgeons, Vol. 218 (2), p. 218-225. ISSN 1072-7515. Article.
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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 ≤4: n = 29; SAS 5−6: n = 227; SAS 7−8: n = 797; SAS 9−10: n = 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.
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