scholarly journals Is surgical Apgar score an effective assessment tool for the prediction of postoperative complications in patients undergoing oesophagectomy?

2018 ◽  
Vol 27 (5) ◽  
pp. 686-691 ◽  
Author(s):  
Shuangjiang Li ◽  
Kun Zhou ◽  
Pengfei Li ◽  
Guowei Che
Keyword(s):  
Postoperative Complications ◽  
Apgar Score ◽  
Assessment Tool ◽  
Effective Assessment ◽  
Surgical Apgar Score

The Surgical Apgar Score Predicts Postoperative Complications in Elderly Patients After Surgery for Colorectal Cancer

2021 ◽  
pp. 000313482110385
Author(s):  
Atsushi Sugimoto ◽  
Tatsunari Fukuoka ◽  
Hisashi Nagahara ◽  
Masatsune Shiutani ◽  
Yasuhito Iseki ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Postoperative Complications ◽  
Elderly Patients ◽  
Apgar Score ◽  
Assessment Tool ◽  
Univariate Analysis ◽  
Operation Time ◽  
Estimated Blood Loss ◽  
Surgical Apgar Score

Objective The surgical Apgar score (SAS) has been validated as a risk assessment tool for postoperative complications. However, the utility of the SAS in elderly patients with colorectal cancer remains unclear. In this study, we evaluated the utility of the SAS for predicting the severe complications in elderly patients with colorectal cancer. Methods We retrospectively analyzed 295 patients underwent radical surgery for colorectal cancer in elderly patients ≥75 years old. The SAS was calculated based on 3 intraoperative parameters: estimated blood loss (EBL), lowest mean arterial pressure, and lowest heart rate. Severe complications were defined as Clavien-Dindo classification grade ≥ IIIa. We divided all patients into 2 groups according to with or without severe complications. The optimal cut-off value of SAS for severe complications has been determined by receiver operator characteristic curve. Predictors for severe complications were analyzed by logistic regression modeling. Results Severe complications were observed in 57 patients (19.3%). Male, rectal cancer, operation time (>240 minutes), EBL (≥120 mL), and a low SAS (≤6) were significantly associated with severe complications in univariate analysis. A multivariate analysis revealed that male, rectal cancer, and a low SAS (≤6) were independent predictors for severe complications. Conclusions A low SAS (≤6) was associated with severe complications after colorectal cancer surgery in elderly patients. The SAS is a valuable predictor for severe complications in elderly patients with colorectal cancer.

scholarly journals Predictive Value of the Surgical Apgar Score on Postoperative Complications in Advanced Gastric Cancer Patients Treated with Neoadjuvant Chemotherapy Followed by Radical Gastrectomy: A Single-center Retrospective Study

2020 ◽  
Author(s):  
Masato Hayashi ◽  
Takaki Yoshikawa ◽  
Masahiro Yura ◽  
Sho Otsuki ◽  
Yukinori Yamagata ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Logistic Regression ◽  
Postoperative Complications ◽  
Neoadjuvant Chemotherapy ◽  
Apgar Score ◽  
Predictive Value ◽  
Assessment System ◽  
Radical Gastrectomy ◽  
Multiple Logistic Regression ◽  
Surgical Apgar Score

Abstract Background The surgical Apgar score (SAS) or modified SAS (mSAS) has been reported as a simple and easy risk assessment system for predicting postoperative complications in primary surgery for gastric cancer. However, few studies have described the SAS’s utility in gastric surgery after neoadjuvant chemotherapy (NAC). Methods One hundred and fifteen patients who received NAC and radical gastrectomy from 2008 and 2015 were included in this study. The SAS was determined by the estimated blood loss (EBL), lowest intraoperative mean arterial pressure, and lowest heart rate. The mSAS was determined by the EBL reassessed using the interquartile values. The predictive values of the SAS/mSAS for postoperative complications were assessed with univariate and multiple logistic regression analyses. Results Among the 115 patients, 41 (35.7%) developed postoperative complications. According to analyses with receiver operating characteristic curves of the SAS and mSAS for predicting postoperative complications, the cut-off value of the mSAS was set at 8. The rates of anastomotic leakage, pancreatic fistula, and arrhythmia in patients with high mSAS (>8) values were higher than in those with low (0-3) and moderate (4-7) mSAS values. A multiple logistic regression analysis showed that the operation time, body mass index, and diabetes mellitus were independent risk factors for postoperative complications. The mSAS was not a significant predictor. Conclusions The predictive value of SAS or mSAS for morbidity may be limited in patients who undergo gastric cancer surgery after NAC. Future prospective studies with a large sample size will be needed to confirm the present results.

scholarly journals Predictive Value of the Surgical Apgar Score on Postoperative Complications in Advanced Gastric Cancer Patients Treated with Neoadjuvant Chemotherapy Followed by Radical Gastrectomy: A Single-center Retrospective Study

2020 ◽  
Author(s):  
Masato Hayashi ◽  
Takaki Yoshikawa ◽  
Masahiro Yura ◽  
Sho Otsuki ◽  
Yukinori Yamagata ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Logistic Regression ◽  
Postoperative Complications ◽  
Neoadjuvant Chemotherapy ◽  
Apgar Score ◽  
Predictive Value ◽  
Assessment System ◽  
Radical Gastrectomy ◽  
Multiple Logistic Regression ◽  
Surgical Apgar Score

Abstract Background The surgical Apgar score (SAS) or modified SAS (mSAS) has been reported as a simple and easy risk assessment system for predicting postoperative complications in primary surgery for gastric cancer. However, few studies have described the SAS’s utility in gastric surgery after neoadjuvant chemotherapy (NAC).Methods One hundred and fifteen patients who received NAC and radical gastrectomy from 2008 and 2015 were included in this study. The SAS was determined by the estimated blood loss (EBL), lowest intraoperative mean arterial pressure, and lowest heart rate. The mSAS was determined by the EBL reassessed using the interquartile values. The predictive values of the SAS/mSAS for postoperative complications were assessed with univariate and multiple logistic regression analyses.Results Among the 115 patients, 41 (35.7%) developed postoperative complications. According to analyses with receiver operating characteristic curves of the SAS and mSAS for predicting postoperative complications, the cut-off value of the mSAS was set at 8. The rates of anastomotic leakage, pancreatic fistula, and arrhythmia in patients with high mSAS (>8) values were higher than in those with low (0-3) and moderate (4-7) mSAS values. A multiple logistic regression analysis showed that the operation time, body mass index, and diabetes mellitus were independent risk factors for postoperative complications. The mSAS was not a significant predictor.Conclusion The predictive value of SAS or mSAS for morbidity may be limited in patients who undergo gastric cancer surgery after NAC. Future prospective studies with a large sample size will be needed to confirm the present results.

“Surgical Apgar Score” predicts postoperative complications after cytoreduction for advanced ovarian cancer

2010 ◽  
Vol 116 (3) ◽  
pp. 370-373 ◽  
Author(s):  
Israel Zighelboim ◽  
Nora Kizer ◽  
Nicholas P. Taylor ◽  
Ashley S. Case ◽  
Feng Gao ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Postoperative Complications ◽  
Apgar Score ◽  
Advanced Ovarian Cancer ◽  
Surgical Apgar Score

PS01.137: CLINICAL IMPACT OF SURGICAL APGAR SCORE IN PREDICTING POSTOPERATIVE COMPLICATIONS AND LONG-TERM PROGNOSIS AFTER ESOPHAGECTOMY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 88-89
Author(s):  
Sonoko Ishida ◽  
Akio Nakagawa ◽  
Tetsu Nakamura ◽  
Taro Oshikiri ◽  
Hiroshi Hasegawa ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Postoperative Complications ◽  
Apgar Score ◽  
Scoring System ◽  
Clinical Stage ◽  
Risk Calculator ◽  
Poor Prognostic Factor ◽  
Long Term Prognosis ◽  
Surgical Apgar Score

Abstract Background Surgical Apgar Score (SAS) is a risk calculator, and is known to predict postoperative complications after surgery. Because it applies three intraoperative parameters, namely estimated blood loss, lowest mean arterial pressure, and lowest heart rate, actual surgical stress is reflected to its scoring system and many studies have reported its usefulness. And in recent years, close relationship between postoperative complications and long-term prognosis has been reported, but there are almost no studies about the relevance between risk calculator of complications and long-term prognosis. Methods A total of 400 patients who underwent esophagectomy for esophageal cancer between January 2007 and January 2017 at our institution were included in this study. Clinicopathological and intraoperative data to calculate SAS were collected from medical records, and a 10-point scoring system based on the original method was used to assign points. Complications classified as Clavien-Dindo grade III or higher were defined as postoperative complications. The relationship between SAS and postoperative complications and long-term prognosis was investigated. Results Postoperative complications occurred in 145 cases (36%). From ROC analysis, we set the SAS cut-off value to 5 points in this study. There were no significant differences in patient's background between the group of SAS ≤ 5 and > 5. Multivariate logistic regression analysis showed that hypertension (P = 0.049) and SAS ≤ 5 (P < 0.0001) were significant predictive factors for postoperative complications. In the prognostic analysis, log-rank analysis showed that patients with SAS ≤ 5 had a significantly poorer prognosis than those with SAS > 5 (P = 0.043), especially in clinical stage 2 or higher esophageal cancer (P = 0.027). In the multivariate analysis, SAS ≤ 5 was revealed to be a significantly poor prognostic factor in clinical stage 2 or higher esophageal cancer (P = 0.029). Conclusion The Surgical Apgar Score can predict postoperative complications, and is also useful to predict long-term prognosis after esophagectomy for esophageal cancer. Disclosure All authors have declared no conflicts of interest.

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