Can the Surgical Apgar Score predict morbidity and mortality in general orthopaedic surgery?
Can the Surgical Apgar Score predict morbidity and mortality in general orthopaedic surgery?
复制标题
DOI：
10.1007/s00264-012-1696-1
复制
发表时间：
2012-12-01
影响因子：
2.7
通讯作者：
Briceno, Jorge
中科院分区：
文献类型：
--
作者：
Urrutia, Julio;Valdes, Macarena;Briceno, Jorge
目的外科Apgar评分（SAS）是根据术中心率、血压和出血量的简单统计;它预测了不同术野的30天主要术后并发症和死亡率，方法对723例连续接受大、中型骨科手术的患者进行SAS前瞻性评估，共18例，月期间。结果术后并发症发生率为千分之一者37例，发生率为5.12%。并发症发生率并没有随着评分的降低而增加（SAS 9-10 = 6.56%，SAS 7-8 = 2.62%，SAS 5-6 = 7.21%，SAS 7 - 8 = 2.62%）SAS a千分之一货币符号4 = 10.2%），相对风险并没有随着分数的降低而增加，似然比也没有随着SAS值的降低而增加，接受脊柱手术的患者亚组除外。C-统计量为0.59（95%置信区间0.48-0.69），为弱判别值。使用阈值为7定义高风险和低风险的患者，SAS只允许脊柱surgery.Conclusions的风险分层的SAS不预测30天的主要并发症和死亡的患者接受普通骨科手术，但它是有用的亚组接受脊柱手术的患者。
Purpose The Surgical Apgar Score (SAS) is a simple tally based on intra-operative heart rate, blood pressure and blood loss; it predicts 30-day major postoperative complications and mortality in different surgical fields, but no validation has been performed in general orthopaedic surgery.Methods A prospective assessment of the SAS in 723 consecutive patients undergoing major and intermediate orthopaedic procedures was performed in an 18-month period. The SAS was calculated immediately after surgery, and the occurrence of major complications or death was registered within a 30-day follow-up.Results Thirty-seven patients had a parts per thousand yen1 complication (5.12 %). The complication rate did not augment as the score decreased (SAS 9-10 = 6.56 %; SAS 7-8 = 2.62 %; SAS 5-6 = 7.21 %; SAS a parts per thousand currency sign4 = 10.2 %), the relative risk did not augment as the score decreased and the likelihood ratio did not increase with decreasing SAS values, except in the subgroup of patients undergoing spine surgery. The C-statistic was 0.59 (95 % confidence interval 0.48-0.69), a weak discriminatory value. Using a threshold of 7 to define high-risk and low-risk patients, the SAS allowed risk stratification only for spine surgery.Conclusions The SAS does not predict 30-day major complications and death in patients undergoing general orthopaedic surgery, but it is useful in the subgroup of patients undergoing spine surgery.