Publication:

Surgical Apgar score in prediction of post-operative complications in gynecological surgery

Background This study was aimed at estimating the ability of 10-point “Surgical Apgar Score” (SAS) to predict postoperative complications in gynecological surgery.

Methods All women undergoing laparotomy (elective and emergency) in the Department of Obstetrics and Gynecology at Kasturba Hospital, Manipal, between November 2014 and June 2015, were included. Age, BMI, comorbidities and postoperative complications were analyzed. The SAS was calculated from the estimated blood loss, lowest heart rate, and lowest mean arterial pressure. Descriptive statistics and univariate statistics were used. Occurrence of major postoperative complications represented the primary outcome.

Results A total of 146 cases meeting the inclusion criteria were analyzed. The patients belonged to the age group of 20-60 years. One or more comorbidities were seen to be present in 50 (34.2%) of the patients. With regard to BMI, 62 (42.5%) of the patients were in the normal category. Major post-operative complications were identified in 11 cases (7.5%). On univariate analyses, occurrence of postoperative complications were associated with presence of comorbidities (p=0.047) and SAS belonging to the high-risk category (p=0.001).

Conclusions The SAS is a significant predictor of postoperative complications following gynecological surgery. This metric, along with a consideration of comorbidities, can be helpful in determining prognosis, directing decision making in the operation theatre, and in postoperative care.