Vascular Surgery
Medical Calculator#Postoperative#APGAR#Gawande

Surgical Apgar Score

Assess surgical risk of complications or death at 30 days, as assessed in the post-operative period.

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Results

Real-time automated computation

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Score
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Risk of complications or death by 30 days after surgery
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Risk of death by 30 days after surgery
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Clinical Parameters (0/3)
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Medical calculation formulas standardized according to evidence-based clinical protocols.
About

The Surgical Apgar Score was developed to allow healthcare providers to assess a patient's condition and risk of major complications or death based on an assessment at the end of any general or vascular surgical procedure.

The surgical score was derived from a retrospective chart analysis and then validated. The primary outcomes measure was incidence of major complication or death within 30 days of operation.

A 10-point score was developed and includes a patient's estimated amount of blood loss, lowest heart rate, and lowest mean arterial pressure during general or vascular operations.

Score is calculated as follows:

Estimated blood loss:

  • >1000 ml - 0 points
  • 601-1000 ml - 1 point
  • 101-600 ml - 2 points
  • ≤ 100 ml - 3 points

Lowest intraoperative mean arterial pressure (mmHg)

  • <40 - 0 points
  • 40-54 - 1 point
  • 55-69 - 2 points
  • ≥70 - 3 points

Lowest intraoperative heart rate (beats/min)

  • >85 - 0 points
  • 76-85 - 1 point
  • 66-75 - 2 points
  • 56-65 - 3 points
  • ≤55 - 4 points

In patients with a score ≤ 4, major complications or death occurred in 59% within 30 days. Among patients with scores of 9 or 10, only 3.6% experienced major complications or died.

Published Literature & References:
  • [1]
    Gawande AA, Kwaan MR, Regenbogen SE, Lipsitz SA, Zinner MJ.: An Apgar score for surgery.Journal of the American College of Surgeons 2007, 204 (2): 201-8