title: Validation of the Surgical Apgar Score in a veteran population undergoing general surgery.
abstract: BACKGROUND
  The Surgical Apgar Score (SAS, a 10-point score calculated using limited intraoperative data) can correlate with postoperative morbidity and mortality after general surgery. We evaluated reliability of SAS in a veteran population.
  
  
  METHODS
  We prospectively collected demographics, medical history, type of surgery, and postoperative outcomes for any veteran undergoing general surgery at our institution (2006-2011). We categorized patients in 4 SAS groups and compared differences in morbidity and mortality.
  
  
  RESULTS
  Our study population included 2,125 patients (SAS ≤4: n = 29; SAS 5-6: n = 227; SAS 7-8: n = 797; SAS 9-10: n = 1,072). Low-SAS patients were likely to have significant preoperative comorbidities and to undergo major surgery, and had increased postoperative morbidity and 30-day mortality.
  
  
  CONCLUSIONS
  The SAS is easily calculated from 3 routinely available intraoperative measurements, correlates with fixed preoperative risk (acute conditions, pre-existing comorbidities, operative complexity), and effectively identifies veterans at high risk for postoperative complications.
authors: Department of Surgery, New York Harbor Healthcare System VAMC, New York, NY; Department of Surgery, New York University School of Medicine, New York, NY. Electronic address: marcovalerio.melis@nyumc.org.
authors: Marcovalerio
authors: M
authors: Melis
authors: Department of Surgery, New York Harbor Healthcare System VAMC, New York, NY; Department of Surgery, New York University School of Medicine, New York, NY; Department of General Surgery, Clinica Chirurgica, University of Sassari, Sassari, Italy.
authors: Antonio
authors: A
authors: Pinna
authors: Department of Surgery, New York Harbor Healthcare System VAMC, New York, NY.
authors: Shunpei
authors: S
authors: Okochi
authors: Department of Surgery, New York Harbor Healthcare System VAMC, New York, NY; Department of Surgery, New York University School of Medicine, New York, NY.
authors: Antonio
authors: A
authors: Masi
authors: Section of Gastroenterology and Medicine Program, Mount Sinai School of Medicine and James J. Peters VAMC, New York, NY.
authors: Alan S
authors: AS
authors: Rosman
authors: Department of Surgery, New York Harbor Healthcare System VAMC, New York, NY.
authors: Dena
authors: D
authors: Neihaus
authors: Department of Surgery, New York Harbor Healthcare System VAMC, New York, NY; Department of Surgery, New York University School of Medicine, New York, NY.
authors: John K
authors: JK
authors: Saunders
authors: Department of Surgery, New York Harbor Healthcare System VAMC, New York, NY; Department of Surgery, New York University School of Medicine, New York, NY.
authors: Elliot
authors: E
authors: Newman
authors: Department of Surgery, New York Harbor Healthcare System VAMC, New York, NY; Department of Surgery, New York University School of Medicine, New York, NY.
authors: Thomas H
authors: TH
authors: Gouge
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013514:Surgical Procedures, Operative; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology; D014728:Veterans