Rajat Choudhari, Rahul Bhat, Keshav Prasad, Bhargava Vyas, Harish Rao , Shrirama Bhat

Department of General Surgery, Kasturba Medical College, Mangalore, India


Objective: Many surgical scoring systems are used to predict operative risk but most are complicated. The aim of the study was to determine the utility of the Surgical Apgar Score (SAS) in predicting post operative mortality and morbidity in general surgical cases.

Material and Methods: This was a prospective observational study. All adult patients for emergency and elective general surgical procedures were included. Intraoperative data was collected, and post operative outcomes were followed up till 30 days. SAS was calculated from intraoperative lowest heart rate, lowest MAP and blood loss.

Results: A total of 220 patients were included in the study. All consecutive general surgical procedures were included. Sixty of the 220 cases were emergency and the rest were elective. Forty-five (20.5%) of the patients developed complication. Mortality rate was 3.2% (7 out of 220). The cases were divided into high risk (0-4), moderate risk (5-8) and low risk (9-10) based on SAS. Complication and mortality rates were 50% and 8.3% in the high risk group, 23% and 3.7% in the moderate risk and 4.2% and 0 in the low risk group, respectively.

Conclusion: The surgical Apgar score is a simple and valid predictor of postoperative morbidity and 30-day mortality among patients undergoing general surgeries. It is applicable to all types of surgeries for emergency and elective cases and irrespective of the patient general condition and type of anesthesia and surgery planned.

Keywords: Surgical Apgar score, postoperative risk, surgical mobidity

Cite this article as: Choudhari R, Bhat R, Prasad K, Vyas B, Rao H, Bhat S. The utility of surgical Apgar score in predicting postoperative morbidity and mortality in general surgery. Turk J Surg 2022; 38 (3): 266-274.


Ethics Committee Approval

This study was approved by Kasturba Medical College Institutional Ethics Committee (Decision number: 10-19/480 Date: 16.10.2019).

Peer Review

Externally peer-reviewed.

Author Contributions

Concept – R.C., R.B., K.P., B.V., H.R., S.B.; Design – R.C., R.B.; Supervision – H.R., S.B., R.B., K.P.; Materials - None; Data Collection and/ or Processing – R.J., R.B., B.V., H.R.; Analysis and/or Interpretation – R.C., R.B., K.P., H.R.; Literature Search – R.C., H.R., B.V.; Writing Manuscript – R.C., B.V., R.B., K.P.; Critical Reviews – R.C., B.V., R.B., K.P., H.R., S.B.

Conflict of Interest

The authors have no conflicts of interest to declare.

Financial Disclosure

The authors declared that this study has received no financial support.