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01-02-2012 | 2011 SSAT Poster Presentation

Surgical Apgar Score Predicts Perioperative Morbidity in Patients Undergoing Pancreaticoduodenectomy at a High-Volume Center

Authors: M. Mura Assifi, John Lindenmeyer, Benjamin E. Leiby, Zvi Grunwald, Ernest L. Rosato, Eugene P. Kennedy, Charles J. Yeo, Adam C. Berger

Published in: Journal of Gastrointestinal Surgery | Issue 2/2012

Abstract

Objectives

Pancreaticoduodenectomy (PD) remains a procedure that carries considerable morbidity. Numerous studies have evaluated factors to predict patients at risk. The aim of this study was to determine whether the surgical Apgar score (SAS) predicts perioperative morbidity and mortality.

Methods

We examined 553 patients undergoing successful PD between January 2000 and December 2010. Postoperative complications were graded using the Clavien scale, and the SAS (range, 0–10) was determined. The Cochran–Armitage test for trend was used to determine the association between grouped SAS scores (0–2, 3–4, 5–6, 7–8, and 9–10) and each of the outcomes.

Results

The average patient age was 64 years, and there was an even distribution of males and females. There were 11 perioperative deaths (2%), 186 grade 2 or higher complications (34%), and 86 major complications (grades 3–5, 16%). Additionally, 61 patients developed pancreatic fistulae (11%). Statistical analysis determined that SAS was a significant predictor of grade 2 or higher complications (p < 0.0001), major morbidity (p = 0.01), and pancreatic fistula (p = 0.04) but not mortality (p = 0.20).

Conclusions

We demonstrate that the SAS is a significant predictor of perioperative morbidity for patients undergoing PD. This score should be used to identify patients at higher risk in order to prioritize use of postoperative critical care beds and hospital resources.

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Title: Surgical Apgar Score Predicts Perioperative Morbidity in Patients Undergoing Pancreaticoduodenectomy at a High-Volume Center
Authors: M. Mura Assifi
John Lindenmeyer
Benjamin E. Leiby
Zvi Grunwald
Ernest L. Rosato
Eugene P. Kennedy
Charles J. Yeo
Adam C. Berger
Publication date: 01-02-2012
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 2/2012
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-011-1733-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Surgical Apgar Score Predicts Perioperative Morbidity in Patients Undergoing Pancreaticoduodenectomy at a High-Volume Center

Abstract

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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