An Apgar Score for Surgery

Gawande, Atul A.; Kwaan, Mary R.; Regenbogen, Scott E.; Lipsitz, Stuart; Zinner, Michael J.

doi:10.1016/j.jamcollsurg.2006.11.011

Cited by 446 publications

(455 citation statements)

References 25 publications

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“…The cases with the SAS≤4 had 14.4 times greater odds than the cases with the SAS≥5 for developing 30-days major complications. Our result is almost consistent with other studies in which these poor-scoring patients were 16 times more likely to develop major complications (5,8). This is very important because the median postoperative hospital stay in our study was 10 days.…”

Section: Discussionsupporting

confidence: 93%

“…The variables are EBL, lowest HR and lowest MAP obtained from the intraoperative handwritten anaesthesia records for the each patient included in the study (5). Each of these 3 variables according to the measured values were assigned particular scoring points after the SAS table ( Figure 1).…”

Section: Calculation Of the Sasmentioning

confidence: 99%

“…The variables are estimated blood loss (EBL), lowest heart rate (HR) and lowest mean arterial pressure (MAP) driven from the intraoperative anesthesia records data calculated at the end of surgery (5). Hence, we conducted a preliminary retrospective research to perceive a utility and validation of the SAS in rating the surgical outcome, length of the ICU and hospital stay in a trauma vulnerable geriatric hip fracture patients.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Implementing the Surgical Apgar Score in patients with trauma hip fracture

Sakan

Pavlović

Milošević

et al. 2015

Injury

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Section: Discussionsupporting

confidence: 93%

Section: Calculation Of the Sasmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Implementing the Surgical Apgar Score in patients with trauma hip fracture

Sakan

Pavlović

Milošević

et al. 2015

Injury

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“…Recently, a simple surgical score inspired by the Apgar Score of Obstetrics was developed to predict the occurrence of 30-day major postoperative complications and mortality [2]. Originally developed in patients undergoing general and vascular surgery, the Surgical Apgar Score (SAS) was later validated in different surgical specialties, including colorectal, urological and gynaecological surgery [3][4][5], as well as in different international scenarios [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…This 10-point score, which allows risk stratification in the postoperative setting, is based on three variables: the estimated blood loss (EBL), lowest heart rate (HR) and lowest mean arterial pressure (MAP) during surgery (Table 1). This score has been demonstrated to be a good predictor of the occurrence of major complications or death within 30 days of surgery; a high score is associated with a low risk of postoperative major complications or death, while a low score is associated with an increased risk [2,8,10].…”

Section: Introductionmentioning

confidence: 99%

Can the Surgical Apgar Score predict morbidity and mortality in general orthopaedic surgery?

Urrutia

Valdés

Zamora

et al. 2012

International Orthopaedics (SICOT)

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Purpose The Surgical Apgar Score (SAS) is a simple tally based on intra-operative heart rate, blood pressure and blood loss; it predicts 30-day major postoperative complications and mortality in different surgical fields, but no validation has been performed in general orthopaedic surgery. Methods A prospective assessment of the SAS in 723 consecutive patients undergoing major and intermediate orthopaedic procedures was performed in an 18-month period. The SAS was calculated immediately after surgery, and the occurrence of major complications or death was registered within a 30-day follow-up. Results Thirty-seven patients had ≥1 complication (5.12 %). The complication rate did not augment as the score decreased (SAS 9-1006.56 %; SAS 7-802.62 %; SAS 5-6 07.21 %; SAS ≤4 010.2 %), the relative risk did not augment as the score decreased and the likelihood ratio did not increase with decreasing SAS values, except in the subgroup of patients undergoing spine surgery. The Cstatistic was 0.59 (95 % confidence interval 0.48-0.69), a weak discriminatory value. Using a threshold of 7 to define high-risk and low-risk patients, the SAS allowed risk stratification only for spine surgery. Conclusions The SAS does not predict 30-day major complications and death in patients undergoing general orthopaedic surgery, but it is useful in the subgroup of patients undergoing spine surgery.

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