How well are prebooked surgical step-down units utilized?

Shum, Serena; Tanzola, Rob; McMullen, Michael; Hopman, Wilma M.; Engen, Dale

doi:10.1016/j.jclinane.2012.10.010

Cited by 6 publications

(3 citation statements)

References 25 publications

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“…The SAS has utility in various surgical disciplines including orthopedic surgery, colorectal surgery, neurosurgery, gynecology and emergency general surgery [7][8][9][10][11][12][13]. Initially, the tool was used to predict 30-day mortality and major complications [3], but now the utility of the SAS has been expanded to predict interventions in surgical step down units, readmissions and intensive care unit (ICU) admissions [13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Validation of the Surgical Apgar Score After Laparotomy at a Tertiary Referral Hospital in Rwanda

et al. 2017

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Section: Introductionmentioning

confidence: 99%

Validation of the Surgical Apgar Score After Laparotomy at a Tertiary Referral Hospital in Rwanda

et al. 2017

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“…We obtained a cut off value <6/>7, a similar value to the obtained by other cohort with HCC [ 25 ]. Indeed, a common observation by different groups is that a cut off value of 6/7 points is optimal to differentiate between low- and high-risk patients [ 49 ]. This reflects that despite individual differences in the preoperative and intraoperative parameters, the SAS predictive efficiency harbors comparable sensibility and specificity values among dissimilar populations.…”

Section: Discussionmentioning

confidence: 99%

Combining ALT/AST Values with Surgical APGAR Score Improves Prediction of Major Complications after Hepatectomy

Mitsiev¹,

Rubio²,

Vp³

et al. 2021

J Surg Res

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Hepatectomy is a complex procedure with high morbidity and mortality. Early prediction/prevention of major complications is highly valuable for patient care. Surgical APGAR score (SAS) has been validated to predict post-surgical complications (PCs). We aimed to define a simple complications classification following hepatectomy based on a therapy-oriented severity Clavien-Dindo classification (CDC). 119 patients undergoing liver resection were included. PCs were determined at follow-up based on CDC. Clinicopathological factors were used to calculate SAS. A receiver-operator characteristic (ROC) curve analysis estimated the predictive value of SAS for PCs. Circulating markers levels of liver injury were analyzed as critical elements on PCs. SAS (P=0.008), estimated blood-loss (P=0.018) and operation time (P=0.0008) were associated with PCs. SAS was reduced in patients with (+) compared to those without (−) complications (6.64±1.84 vs 5.70±1.79, P=0.0079). The area-under-the-curve was 0.646 by ROC, indicating an acceptable discrimination with 65% possibility to distinguish (−) and (+) groups (P=0.004). Best cutoff value for SAS was ≤6/≥7, at which sensitivity and specificity were maximal. ALT/ASL levels were significantly different within the group with 9-10 SAS points (P=0.01 and 0.02). In conclusion, SAS provides accurate risk stratification for major PCs after hepatectomy, and might help improving the overall patient outcome.

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“…One clear advantage is that the SAS method does not require elaborated calculations. Previous groups have added considerable amount of evidence for the efficient predictive use of the SAS score in multicenter studies with general surgical patients [43][44][45], and in a relevant manner on interventions involving resections of esophagus, stomach, colon, radical cystectomy, thyroid, and aorta [46,19,47,48]. Before the introduction of the SAS score by Gawande et.…”

Section: Discussionmentioning

confidence: 99%

Combining ALT/AST values with surgical APGAR score improves prediction of major complications after hepatectomy

Mitsiev

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Background: Hepatectomy is a complex procedure with high morbidity and mortality. Early prediction/prevention of major complications is highly valuable for patient care. Surgical APGAR score (SAS) has been validated to predict post-surgical complications (PCs). Goal: We aimed to define a simple complications classification following hepatectomy based on a therapy-oriented severity Clavien-Dindo classification (CDC). Methods: 119 patients undergoing liver resection were included. PCs were determined at follow-up based on CDC. Clinicopathological factors were used to calculate SAS. A receiver-operator characteristic (ROC) curve analysis estimated the predictive value of SAS for PCs. Circulating markers levels of liver injury were analyzed as critical elements on PCs. Results: SAS (P=0.008), estimated blood-loss (P=0.018) and operation time (P=0.0008) were associated with PCs. SAS was reduced in patients with (+) compared to those without (-) complications (6.64±1.84 vs 5.70±1.79, P=0.0079). The area-under-the-curve was 0.646 by ROC, indicating an acceptable discrimination with 65% possibility to distinguish (-) and (+) groups (P=0.004). Best cutoff value for SAS was ≤6/≥7, at which sensitivity and specificity were maximal. ALT/ASL levels were significantly different within the group with 9-10 SAS points (P=0.01 and 0.02). Conclusion: SAS provides accurate risk stratification for major PCs after hepatectomy, and might help improving the overall patient outcome.

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How well are prebooked surgical step-down units utilized?

Cited by 6 publications

References 25 publications

Validation of the Surgical Apgar Score After Laparotomy at a Tertiary Referral Hospital in Rwanda

Validation of the Surgical Apgar Score After Laparotomy at a Tertiary Referral Hospital in Rwanda

Combining ALT/AST Values with Surgical APGAR Score Improves Prediction of Major Complications after Hepatectomy

Combining ALT/AST values with surgical APGAR score improves prediction of major complications after hepatectomy

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