Validation of the Surgical Apgar Score in a veteran population undergoing general surgery

J Am Coll Surg. 2014 Feb;218(2):218-25. doi: 10.1016/j.jamcollsurg.2013.10.021. Epub 2013 Nov 1.

Abstract

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.

Publication types

  • Comparative Study
  • Validation Study

MeSH terms

  • Aged
  • Female
  • Follow-Up Studies
  • Health Status Indicators*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Morbidity / trends
  • Postoperative Complications / epidemiology*
  • Prospective Studies
  • Reproducibility of Results
  • Risk Assessment / methods*
  • Risk Factors
  • Surgical Procedures, Operative*
  • Survival Rate / trends
  • United States / epidemiology
  • Veterans*