Antonio Masi1, Salvatore Amodeo2, Ioannis Hatzaras2, Antonio Pinna3, Alan S Rosman4, Steven Cohen2, John K Saunders1, Russell Berman2, Elliot Newman1, Garth H Ballantyne1, Leon H Pachter2, Marcovalerio Melis5. 1. Department of Surgery, New York Harbor Healthcare System, 423 East 23rd Street, New York, NY 10010, USA; Department of Surgery, NYU School of Medicine, New York, 550 1st Avenue, New York, NY 10016, USA. 2. Department of Surgery, NYU School of Medicine, New York, 550 1st Avenue, New York, NY 10016, USA. 3. Department of Surgery, New York Harbor Healthcare System, 423 East 23rd Street, New York, NY 10010, USA; Department of Surgery, NYU School of Medicine, New York, 550 1st Avenue, New York, NY 10016, USA; Department of General Surgery - Clinica Chirurgica, University of Sassari, Sassari, Italy. 4. Section of Gastroenterology and Medicine Program Mount Sinai School of Medicine and James J. Peters VAMC, NY, USA. 5. Department of Surgery, New York Harbor Healthcare System, 423 East 23rd Street, New York, NY 10010, USA; Department of Surgery, NYU School of Medicine, New York, 550 1st Avenue, New York, NY 10016, USA. Electronic address: marcovalerio.melis@nyumc.org.
Abstract
BACKGROUND: We investigated whether the surgical Apgar score (SAS) may enhance the Veterans Affairs Surgical Quality Improvement Program (VASQIP) risk assessment for prediction of early postoperative outcomes. METHODS: We retrospectively evaluated demographics, medical history, procedure, SAS, VASQIP assessment, and postoperative data for patients undergoing major/extensive intra-abdominal surgery at the Manhattan Veterans Affairs between October 2006 and September 2011. End points were overall morbidity and 30-, 60- , and 90-day mortality. Pearson's chi-square, ANOVA, and multivariate regression modeling were employed. RESULTS: Six hundred twenty-nine patients were included. Apgar groups did not differ in age, sex, and race. Low SASs were associated with worse functional status, increased postoperative morbidity, and 30-, 60- , and 90-day mortality rates. SAS did not significantly enhance VASQIP prediction of postoperative outcomes, although a trend was detected. Multivariate analysis confirmed SAS as an independent predictor of morbidity and mortality. CONCLUSIONS: SAS effectively identifies veterans at high risk for poor postoperative outcome. Additional studies are necessary to evaluate the role of SAS in enhancing VASQIP risk prediction. Published by Elsevier Inc.
BACKGROUND: We investigated whether the surgical Apgar score (SAS) may enhance the Veterans Affairs Surgical Quality Improvement Program (VASQIP) risk assessment for prediction of early postoperative outcomes. METHODS: We retrospectively evaluated demographics, medical history, procedure, SAS, VASQIP assessment, and postoperative data for patients undergoing major/extensive intra-abdominal surgery at the Manhattan Veterans Affairs between October 2006 and September 2011. End points were overall morbidity and 30-, 60- , and 90-day mortality. Pearson's chi-square, ANOVA, and multivariate regression modeling were employed. RESULTS: Six hundred twenty-nine patients were included. Apgar groups did not differ in age, sex, and race. Low SASs were associated with worse functional status, increased postoperative morbidity, and 30-, 60- , and 90-day mortality rates. SAS did not significantly enhance VASQIP prediction of postoperative outcomes, although a trend was detected. Multivariate analysis confirmed SAS as an independent predictor of morbidity and mortality. CONCLUSIONS: SAS effectively identifies veterans at high risk for poor postoperative outcome. Additional studies are necessary to evaluate the role of SAS in enhancing VASQIP risk prediction. Published by Elsevier Inc.
Entities:
Keywords:
Alimentary tract; Major Surgery; Surgical Apgar score