Association between the Surgical Apgar Score and Perioperative Complications after Radical Prostatectomy

Area of Science:

• Urology
• Surgical Oncology
• Anesthesiology

Background:

• Prostate cancer surgery carries risks of perioperative adverse events (PAE).
• Predictive tools are needed to identify high-risk patients undergoing radical prostatectomy.
• The Surgical Apgar Score (SAS) assesses intraoperative risk but its utility post-prostatectomy is unclear.

Purpose of the Study:

• To determine if the Surgical Apgar Score (SAS) can identify patients at risk for perioperative adverse events (PAE) after radical prostatectomy for prostate cancer.

Main Methods:

• Retrospective analysis of 994 patients undergoing radical prostatectomy (2010-2013).
• SAS calculated from anesthesia records to predict 30-day postoperative PAE.
• PAE classified using standardized systems.

Main Results:

• 45.4% of patients experienced adverse events; 9.9% had high-grade events.
• Lower SAS independently predicted any (p < 0.001) and low-grade (p = 0.001) adverse events in open retropubic radical prostatectomy (ORRP).
• Robot-assisted prostatectomy adverse events were not associated with SAS.

Conclusions:

• Lower SAS values identify patients at risk for adverse events following ORRP.
• SAS may aid in outcome assessment for radical prostatectomy.
• Highlights the importance of integrated surgical and anesthesiology management.