Utility of the surgical apgar score: Validation in 4119 patients (2024)

Regenbogen, S. E., Ehrenfeld, J. M., Lipsitz, S. R., Greenberg, C. C., Hutter, M. M., & Gawande, A. A. (2009). Utility of the surgical apgar score: Validation in 4119 patients. Archives of Surgery, 144(1), 30-36. https://doi.org/10.1001/archsurg.2008.504

Utility of the surgical apgar score: Validation in 4119 patients. / Regenbogen, Scott E.; Ehrenfeld, Jesse M.; Lipsitz, Stuart R. et al.
In: Archives of Surgery, Vol. 144, No. 1, 01.2009, p. 30-36.

Research output: Contribution to journal › Article › peer-review

Regenbogen, SE, Ehrenfeld, JM, Lipsitz, SR, Greenberg, CC, Hutter, MM & Gawande, AA 2009, 'Utility of the surgical apgar score: Validation in 4119 patients', Archives of Surgery, vol. 144, no. 1, pp. 30-36. https://doi.org/10.1001/archsurg.2008.504

Regenbogen SE, Ehrenfeld JM, Lipsitz SR, Greenberg CC, Hutter MM, Gawande AA. Utility of the surgical apgar score: Validation in 4119 patients. Archives of Surgery. 2009 Jan;144(1):30-36. doi: 10.1001/archsurg.2008.504

Regenbogen, Scott E. ; Ehrenfeld, Jesse M. ; Lipsitz, Stuart R. et al. / Utility of the surgical apgar score : Validation in 4119 patients. In: Archives of Surgery. 2009 ; Vol. 144, No. 1. pp. 30-36.

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title = "Utility of the surgical apgar score: Validation in 4119 patients",

abstract = "Objectives: To confirm the utility of a 10-point Surgical Apgar Score to rate surgical outcomes in a large cohort of patients. Design: Using electronic intraoperative records, we calculated Surgical Apgar Scores during a period of 2 years (July 1, 2003, through June 30, 2005). Setting: Major academic medical center. Patients: Systematic sample of 4119 general and vascular surgery patients enrolled in the National Surgical Quality Improvement Program surgical outcomes database at a major academic medical center. Main Outcome Measures: Incidence of major post-operative complications and/or death within 30 days of surgery. Results: Of 1441 patients with scores of 9 to 10, 72 (5.0%) developed major complications within 30 days, including 2 deaths (0.1%). By comparison, among 128 patients with scores of 4 or less, 72 developed major complications (56.3%; relative risk, 11.3; 95% confidence interval, 8.6-14.8; P<.001), of whom 25 died (19.5%; relative risk, 140.7; 95% confidence interval, 33.7-587.4; P<.001). The 3-variable score achieves C statistics of 0.73 for major complications and 0.81 for deaths. Conclusions: The Surgical Apgar Score provides a simple, immediate, objective means of measuring and communicating patient outcomes in surgery, using data routinely available in any setting. The score can be effective in identifying patients at higher- and lower-than-average likelihood of major complications and/or death after surgery and may be useful for evaluating interventions to prevent poor outcomes.",

author = "Regenbogen, {Scott E.} and Ehrenfeld, {Jesse M.} and Lipsitz, {Stuart R.} and Greenberg, {Caprice C.} and Hutter, {Matthew M.} and Gawande, {Atul A.}",

year = "2009",

month = jan,

doi = "10.1001/archsurg.2008.504",

language = "English (US)",

volume = "144",

pages = "30--36",

journal = "Archives of Surgery",

issn = "0004-0010",

publisher = "American Medical Association",

number = "1",

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T1 - Utility of the surgical apgar score

T2 - Validation in 4119 patients

AU - Regenbogen, Scott E.

AU - Ehrenfeld, Jesse M.

AU - Lipsitz, Stuart R.

AU - Greenberg, Caprice C.

AU - Hutter, Matthew M.

AU - Gawande, Atul A.

PY - 2009/1

Y1 - 2009/1

N2 - Objectives: To confirm the utility of a 10-point Surgical Apgar Score to rate surgical outcomes in a large cohort of patients. Design: Using electronic intraoperative records, we calculated Surgical Apgar Scores during a period of 2 years (July 1, 2003, through June 30, 2005). Setting: Major academic medical center. Patients: Systematic sample of 4119 general and vascular surgery patients enrolled in the National Surgical Quality Improvement Program surgical outcomes database at a major academic medical center. Main Outcome Measures: Incidence of major post-operative complications and/or death within 30 days of surgery. Results: Of 1441 patients with scores of 9 to 10, 72 (5.0%) developed major complications within 30 days, including 2 deaths (0.1%). By comparison, among 128 patients with scores of 4 or less, 72 developed major complications (56.3%; relative risk, 11.3; 95% confidence interval, 8.6-14.8; P<.001), of whom 25 died (19.5%; relative risk, 140.7; 95% confidence interval, 33.7-587.4; P<.001). The 3-variable score achieves C statistics of 0.73 for major complications and 0.81 for deaths. Conclusions: The Surgical Apgar Score provides a simple, immediate, objective means of measuring and communicating patient outcomes in surgery, using data routinely available in any setting. The score can be effective in identifying patients at higher- and lower-than-average likelihood of major complications and/or death after surgery and may be useful for evaluating interventions to prevent poor outcomes.

AB - Objectives: To confirm the utility of a 10-point Surgical Apgar Score to rate surgical outcomes in a large cohort of patients. Design: Using electronic intraoperative records, we calculated Surgical Apgar Scores during a period of 2 years (July 1, 2003, through June 30, 2005). Setting: Major academic medical center. Patients: Systematic sample of 4119 general and vascular surgery patients enrolled in the National Surgical Quality Improvement Program surgical outcomes database at a major academic medical center. Main Outcome Measures: Incidence of major post-operative complications and/or death within 30 days of surgery. Results: Of 1441 patients with scores of 9 to 10, 72 (5.0%) developed major complications within 30 days, including 2 deaths (0.1%). By comparison, among 128 patients with scores of 4 or less, 72 developed major complications (56.3%; relative risk, 11.3; 95% confidence interval, 8.6-14.8; P<.001), of whom 25 died (19.5%; relative risk, 140.7; 95% confidence interval, 33.7-587.4; P<.001). The 3-variable score achieves C statistics of 0.73 for major complications and 0.81 for deaths. Conclusions: The Surgical Apgar Score provides a simple, immediate, objective means of measuring and communicating patient outcomes in surgery, using data routinely available in any setting. The score can be effective in identifying patients at higher- and lower-than-average likelihood of major complications and/or death after surgery and may be useful for evaluating interventions to prevent poor outcomes.

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