Surgical Apgar Score Predicts Post-Laparatomy Complications

Dullo M1, Ogendo SWO2, Nyaim EO2

1 − Kitui District Hospital

2 − School of Medicine, University of Nairobi

Correspondence to: Dr. Michael Dullo, P.O. Box 103241-00101, Nairobi, Kenya Email: micdullo@yahoo.com

Abstract

Introduction: The Surgical Apgar score (SAS) presents a simple, immediate and an objective means of determining surgical outcomes. The score has not been widely validated in low resource settings where it would be most valuable. This study aimed to evaluate its accuracy and applicability for patients undergoing laparatomy at Kenyatta National Hospital (KNH), Nairobi.

 

Methodology: Using intra-operative records, we calculated Surgical Apgar Scores for 152 patients during a 6-month study between March 2011 and August 2011. Our main outcome measures were the incidence of major postoperative complications and/or death within 30 days of surgery.

 

Results: The mean age of the patients evaluated was 35.18 years, range of 14 to 80 years. Most laparatomies were emergency procedures (86.8%) with mean duration for surgery of 131 minutes. The overall rate for major complications and mortality was 40.8% and 7.9% respectively. Common morbidities were superficial and deep wound infection, anastomotic leakage and wound dehiscence. The mean SAS for patients with complications was lower (4.0) compared to those without (5.73) (p<0.001). Patients categorised as high risk had a 58.3% complication rate compared to low risk patients with 16.6 % (p=0.04). These outcomes compare favourably with other studies. The SAS demonstrated good predictive accuracy for post-operative morbidity (ROC area under the curve of 0.796, CI 0.727-0.865).

 

Conclusion: This study confirms the SAS as adequate in stratification of post-operative risk of major complications following laparatomy in our setting with good predictive accuracy.

ssk_logo.png

The Annals of African Surgery is the official publication of the Surgical Society of Kenya.

 

All content copyright © 2020 Annals of African Surgery.

ISSN (print): 1999-9674; ISSN (online): 2523-0816

Main Office Location: Menelik Medical Centre, Menelik Road, off Ngong Road, Nairobi. First floor.

Telephone: +254715260499

Email: info@annalsofafricansurgery.com.

 

The content on this site is intended for health professionals. Advertisements on this site do not constitute a guarantee or endorsement by the journal, Association, or publisher of the quality or value of such product or of the claims made for it by its manufacturer.

70.png
69.jpg
hinari_header_en.png
  • Twitter
  • Facebook Social Icon
  • LinkedIn