DOAJ
Surgical Apgar Score as a Predictor of 30-Day Postoperative Complications Following Emergency Laparotomy: A Prospective Observational Study
By Kamad Dixit, Sudhanshu Sharma and Rahul Kumar.
Abstract
Background
Emergency laparotomy carries high morbidity and mortality, and simple tools for postoperative risk stratification are needed, particularly in resource-limited settings. The Surgical Apgar Score (SAS) is a 10-point score calculated from three routinely recorded intraoperative variables: estimated blood loss, lowest mean arterial pressure and lowest heart rate.
Objective
To evaluate the Surgical Apgar Score as a predictor of 30-day postoperative complications and mortality following emergency laparotomy.
Methods
This prospective observational study included 107 adult patients who underwent emergency laparotomy at Government Medical College, Orai, Jalaun, Uttar Pradesh, from August 2025 to July 2026. The SAS was calculated at the end of surgery, and patients were grouped as high risk (0–4), medium risk (5–6) or low risk (7–10). Complications within 30 days were graded by the Clavien-Dindo classification. Outcomes were compared across the risk groups, and predictive accuracy was assessed by receiver operating characteristic (ROC) curve analysis.