Surgical Apgar Score Essential to Decreasing Mortality, Physicians Say

An objective assessment for post-surgical patients is critical to decreasing mortality and improving patient outcomes, according to an editorial published in Anesthesiology by Atul A. Gawande, MD, MPH, and Scott E. Regenbogen, MD, MPH, of the Brigham and Women's Center for Surgery and Public Health and the Department of Health Policy and Management at the Harvard School of Public Health.

According to the editorial, the development of the Apgar score, a simple, 10-point score to objectively determine neonatal condition, was a major step in preventing infant mortality and tailoring care for different infants. According to the authors, early studies suggest that an Apgar-like score could be constructed for post-surgical patients by summing grades for the amount of blood lost, lowest blood pressure and lowest heart rate during operation. The Surgical Apgar Score could capture several factors that contribute to the patient's condition after surgery, including overall fitness coming into the operation, intraoperative anesthesia management and magnitude and technical performance of the procedure.

A study published in Anesthesiology in 2011, titled "Expansion of the surgical Apgar Score across all surgical subspecialties as a means to predict postoperative mortality," validates the Surgical Apgar Score across 123,864 procedures and demonstrates a strong correlation with mortality across a variety of subspecialties.

The editorial's authors say adoption of such a score is essential, despite the common belief by surgeons and anesthesiologists that their subjective impressions of a patient's post-surgical condition are accurate and require no extra assessment. The authors say further research into the efficacy of the score and eventual adoption are critical to preventing some of the 150,000 patient deaths within 30 days of surgery that occur every year.

Read the editorial in Anesthesiology about the surgical Apgar score.

Read more on anesthesia:

-Eladur Patch for Low Back Pain Doesn't Meet Study Goals

-Brief Anesthetic Exposure in Infancy Does Not Affect Test Scores in Adolescence

-National Institute on Drug Abuse Releases Teaching Tools for Physicians

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