Abstract PR405

Abstract

Background & Objectives: The Surgical Apgar Score (SAS) is a simple 10 point scoring system that has been shown to be predictive of major postoperative complications and death after surgery. The aim of the study was to evaluate the predictive ability of this score in a Caribbean cohort undergoing emergency abdominal surgery. Materials & Methods: The SAS was calculated by chart review from the anesthesia records of patients undergoing emergency general surgery during a two-year period. The perioperative surgical records of these patients were examined for in-hospital complications and mortality. The predictive ability of the score for major complications and death was tested. Results: Of the 220 patients studied, 67% experienced major complications and 33% died. The highest complication rate occurred in the low scoring groups. Low scoring patients (SAS <4) had four times higher risk of major complications when compared to higher scoring (SAS ≥ 7) groups (OR 4.21, 95% CI, 2.5-7.3, p <0.001). Logistic regression analyses showed that the lower SAS score, the higher the incidence of complications and mortality [OR: 0.57, (95% CI 0.45-0.73, p <0.005]. This was also confirmed by C-statistic of the SAS, which was 0.71 (95% CI 0.68-0.73, p <0.0001) for major complications or death. The area under the Receiver Operating Characteristic (ROC) curve for SAS was 0.71 (95% CI 0.64, 0.78). Conclusion: SAS is a simple and objective perioperative score that can be used by surgeons and anesthesiologists to predict the risk of perioperative complications and mortality in patients undergoing emergency abdominal surgery in our setting. Disclosure of Interest: None declared