Surgical Apgar score (SAS) predicts perioperative morbidity, mortality, and length of stay in patients undergoing esophagectomy at a high-volume center.

Publication/Presentation Date

9-1-2017

Abstract

BACKGROUND: Esophagectomy carries considerable morbidity. Many studies have evaluated factors to predict patients at risk. This study aimed to determine whether the surgical Apgar score (SAS) predicts complications and length of stay (LOS) for patients undergoing esophagectomy.

STUDY DESIGN: We evaluated 212 patients undergoing esophagectomy. Postoperative complications were graded using the Clavien-Dindo scale and the SAS was determined. Association of SAS with incidence of complications was evaluated using the Cochran-Armitage trend test between grouped SAS scores (0-2, 3-4, 5-6, 7-8, 9-10) and each of the outcomes. Correlation of SAS with LOS was evaluated using competing risks proportional hazards regression.

RESULTS: The average patient age was 63.5 years (range 31-86), and the average blood loss was 284 mL (range 50-4000). The median LOS was 10 days. There was a significant association between SAS and grade 2 or higher (P = 0.0002) and grade 3 or higher (P <  0.0001) complications. The perioperative mortality rate was 5.2% (n = 11) with lower SAS being associated with greater mortality. LOS was also associated with SAS (P <  0.0001).

CONCLUSIONS: We demonstrate that SAS is a significant predictor of complications and LOS for patients undergoing esophagectomy. SAS should be used to identify lower risk patients to prioritize use of critical care beds and hospital resources.

Volume

116

Issue

3

First Page

359

Last Page

364

ISSN

1096-9098

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

28464255

Department(s)

Administration and Leadership

Document Type

Article

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