title: Evaluation of the surgical apgar score in patients undergoing Ivor-Lewis esophagectomy.
abstract: BACKGROUND
  The Surgical Apgar Score is a simple outcome score based on intraoperative parameters. The scoring system is recently validated in patients undergoing esophagectomy but without comparable results. This study evaluated the ability of the original and modified Surgical Apgar Scores to predict major complications in a patient population undergoing Ivor-Lewis esophagectomy.
  
  
  METHODS
  We retrospectively examined 234 patients who successfully underwent Ivor-Lewis esophagectomy at Rigshospitalet, Copenhagen from November 23, 2011 till November 23, 2014. Major complications were defined as Clavien-Dindo grade IIIa or higher within 30 days after surgery. Univariate and multivariate analyses were performed to assess factors associated with major complications. Receiver operating characteristics were performed for determination of the predictive value of the Surgical Apgar Score scoring systems.
  
  
  RESULTS
  There were 64 (27.4%) patients with at least one major complication and 4 (1.7%) deaths. The original and modified versions of the Surgical Apgar Score were not associated with major complications and the scoring systems showed no significant predictive value when receiver operating characteristics were performed.
  
  
  CONCLUSIONS
  The original or modified versions of the Surgical Apgar Score could possibly be useful in some subgroups of esophagectomy patients, but should not be considered to have a general predictive value. J. Surg. Oncol. 2017;115:186-191. © 2017 Wiley Periodicals, Inc.
authors.affiliation: The Abdominal Centre, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Simon
authors.initials: S
authors.lastname: Strøyer
authors.affiliation: Department of Anaesthesiology, The Abdominal Centre, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Teit
authors.initials: T
authors.lastname: Mantoni
authors.affiliation: Department of Surgical Gastroenterology, The Abdominal Centre, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Lars Bo
authors.initials: LB
authors.lastname: Svendsen
mesh_terms: D000368:Aged; D001034:Apgar Score; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D007432:Intraoperative Period; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Ivor-Lewis esophagectomy; complications; esophageal cancer; morbidity; surgical score