A Retrospective Study to Assess the Efficacy of Surgical APGAR Score

Introduction: In today’s era cost of health care is of growing importance and it is important to recognize patients at increased risk of post-operative morbidity and mortality and to find interventions to reduce the risk. Hence, there is a need of an objective prognostic tool to assess the post-operative outcome of patients. The Surgical APGAR score (SAS) is a simple score that uses intraoperative information on hemodynamics and blood loss of patient to predict post-operative morbidity and mortality. Score on a scale of 0-10 is calculated from three parameters collected during the operative procedure, lowest heart rate (HR), lowest mean arterial pressure (MAP), and estimated blood loss. Materials and Methods: A 12 months retrospective study was done in Dr Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation. Emergency and elective major cases were included in this study. SAS calculated based on intraoperative parameters lowest MAP, lowest HR, and amount of blood loss. Results: A total of 403 patients were studied, age ranged from 18 to 70 years. 246 elective and 157 emergency surgeries, the majority were gastrointestinal surgeries. SAS was significantly associated with post-operative morbidity and mortality within 30 days (P < 0.001). Of 403 patients, 121 had SAS 4 or less. Complications noted in 65 out of 121 patients. By comparison among 105 patients with SAS 8 - 10 nobody had complications. Conclusion: SAS is a simple prognostic tool for assessing post-operative outcome in general surgical patients.