Surgical Apgar score as a complication predictor in gastrointestinal oncologic surgery

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Predictive Analytics in Medicine

Background:

• Surgical resection is key for gastrointestinal (GI) cancer cure but carries significant risks.
• The Surgical Apgar Score (SAS) offers immediate, objective feedback on surgical stress.
• Predicting postoperative complications is crucial for managing GI cancer patients.

Purpose of the Study:

• To assess the predictive performance of the Surgical Apgar Score (SAS) for 30-day complications.
• To evaluate SAS in patients undergoing curative surgery for primary GI cancer.

Main Methods:

• Prospective observational study of 50 GI cancer patients.
• Patients categorized into low SAS (≤4) and high SAS (≥5) groups.
• Complications defined as Clavien-Dindo grade II-V events; Cox regression analysis used.

Main Results:

• Overall postoperative morbidity was 50.0%; no mortality.
• Higher complication rates observed in the low SAS group (83.3%) compared to the high SAS group (45.5%).
• Multivariate analysis identified BMI, SAS, surgery duration, and ephedrine use as significant predictors of adverse outcomes.

Conclusions:

• The Surgical Apgar Score (SAS) is an independent predictor of 30-day postoperative morbidity in GI cancer surgery.
• SAS provides reliable risk sub-stratification, particularly in high-risk populations (ASA≥3).