title: Post-operative morbidity and mortality in pancreatic surgery. The role of surgical Apgar score.
abstract: BACKGROUND
  Morbidity and mortality rates after pancreatic resection still remain high. The surgical Apgar score (SAS) has been recently introduced as predictive value of perioperative outcomes after pancreatic surgery. Aim of the study was to detect significant parameters affecting post-operative outcomes in pancreatic surgery, and to evaluate the role of SAS in predicting morbidity, pancreatic fistulas and mortality.
  
  
  METHODS
  Data were collected from 143 patients who had undergone pancreatic resection for pancreatic and periampullary adenocarcinoma. Pre-operative and intra-operative parameters were statistically analyzed to evaluate their potential prognostic effects.
  
  
  RESULTS
  A low SAS (p = 0.001), hypo-albuminemia (p = 0.003), and the need for blood transfusions (p = 0.05) were significant independent predictors of postoperative morbidity. The SAS was demonstrated to significantly predict major complications (p = 0.001) surgical site infections (p = 0.001) and mortality (p = 0.001).
  
  
  CONCLUSIONS
  The SAS provides a simple, immediate, and objective means of measuring patient outcomes in surgery. This score should be used to identify patients at high risk of major complications and death after pancreatic surgery and may be useful to optimize the use of postoperative critical care beds and hospital resources.
authors.affiliation: Department of General Surgery, Surgical Department of Clinical Sciences, Biomedical Technologies and Translational Medicine, Faculty of Medicine and Psychology, University of Rome La Sapienza, St. Andrea Hospital, Via di Grottarossa, 1035-39, 00189 Rome, Italy. marco.latorre@uniroma1.it
authors.forename: Marco
authors.initials: M
authors.lastname: La Torre
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ramacciato
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nigri
authors.forename: Genoveffa
authors.initials: G
authors.lastname: Balducci
authors.forename: Marco
authors.initials: M
authors.lastname: Cavallini
authors.forename: Michele
authors.initials: M
authors.lastname: Rossi
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ziparo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001034:Apgar Score; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects / Q000401:mortality*; D011183:Postoperative Complications / Q000175:diagnosis*