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Validation of the Surgical Apgar Score in a veteran population undergoing general surgery
Marcovalerio Melis1, Antonio Pinna2, Shunpei Okochi3
1Department of Surgery, New York Harbor Healthcare System VAMC, New York, NY; Department of Surgery, New York University School of Medicine, New York, NY.
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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