UTILITY OF SURGICAL APGAR SCORE TO PREDICTPOSTOPERATIVE MORBIDITY AND MORTALITY IN LAPAROTOMY PATIENTS - A PROSPECTIVE STUDY

Abstract

Background:This Ten-point Surgical Apgar Score also known as the SAS score predicts postoperative mortality and morbidity in patients undergoing laparotomy. Method:50 patients undergoing laparotomy surgery were enrolled. 42 of these were emergency surgeries forintestinal obstruction,perforationperitonitis, subacute intestinal obstruction,penetrating injury,blunt injury to abdomen, ovarian cyst rest.8 cases were elective surgeries. The Surgical Apgar Score (SAS) was calculated intra-operatively based on estimated blood loss, lowest mean arterial pressure and lowest heart rate. Post-operative complications and mortality were recorded. Results:In our study 10 out of 12 patients in the high-risk group developed complications. In other words, 83.34%developed complications.7 out of18 patients belonging to the medium-risk group developed complications which is 38.8%.Only 5 out of 20 patients in the low-risk group suffered from complications. 75% of the patients in the low-risk groups did not have any major complications following the surgery. This was statistically significant with a p-value of 0.04. Conclusions:In our situation, laparotomy is still considerably high related with morbidity and mortality. The Surgical Apgar Score is excellent at classifying the postoperative risk of major complication following laparotomyusing straightforward and highly varying intraoperative measurements. The SAS score alarms the surgeon and empowers him to take proactive action19.