Marcovalerio Melis1, Antonio Pinna2, Shunpei Okochi3, Antonio Masi4, Alan S Rosman5, Dena Neihaus3, John K Saunders4, Elliot Newman4, Thomas H Gouge4. 1. Department of Surgery, New York Harbor Healthcare System VAMC, New York, NY; Department of Surgery, New York University School of Medicine, New York, NY. Electronic address: marcovalerio.melis@nyumc.org. 2. Department of Surgery, New York Harbor Healthcare System VAMC, New York, NY; Department of Surgery, New York University School of Medicine, New York, NY; Department of General Surgery, Clinica Chirurgica, University of Sassari, Sassari, Italy. 3. Department of Surgery, New York Harbor Healthcare System VAMC, New York, NY. 4. Department of Surgery, New York Harbor Healthcare System VAMC, New York, NY; Department of Surgery, New York University School of Medicine, New York, NY. 5. Section of Gastroenterology and Medicine Program, Mount Sinai School of Medicine and James J. Peters VAMC, New York, NY.
Abstract
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. Published by Elsevier Inc.
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. Published by Elsevier Inc.
Authors: Nina E Glass; Antonio Pinna; Antonio Masi; Alan S Rosman; Dena Neihaus; Shunpei Okochi; John K Saunders; Ioannis Hatzaras; Steven Cohen; Russell Berman; Elliot Newman; H Leon Pachter; Thomas H Gouge; Marcovalerio Melis Journal: J Gastrointest Surg Date: 2015-01-09 Impact factor: 3.452