Can the surgical Apgar score predict morbidity and mortality in general surgery?


  • Sajan Sehgal Department of General Surgery, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
  • Nagaraj Ravishankar Department of General Surgery, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
  • Divakar Sullery Raghupathi Department of General Surgery, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
  • Nalini Kotekar Department Of Anaesthesiology, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India



Emergency surgeries, Morbidity, Surgical Apgar score, 30 day mortality


Background: The objective of the study was to evaluate the effectiveness of surgical Apgar score (SAS) in predicting morbidity and 30 day mortality in general surgical procedures and also to compare the predictability of the score in elective and emergency surgeries for outcome thereafter.

Methods: 120 patients undergoing general surgical procedures in JSS Hospital, Mysuru from November 2016 to April 2018 were included in the study. Necessary data was collected. Surgical Apgar score was calculated for each patient and analysis done.

Results: 75% of the patients included in the study were in the age group of over 40 years. Around 23% of the patients belong to age group>60 years. 18.25% of patients in the age group >60 years had a low Apgar score of <4. Whereas surgical Apgar score 9-10 was highest in the age group <40 years. Diabetes, hypertension, smoking were significantly associated with post-operative complications. 74.25% of the surgeries involved in the study were elective in nature. Amongst the 35 patients with an Apgar score of <4, major complications occurred in 33% and a 30-day mortality rate of 23% was observed. Morbidity was higher in emergency surgeries as compared to elective surgical procedures.

Conclusions: Surgical Apgar score is a simple and useful method of predicting the morbidity and the 30 day mortality of patients undergoing general surgical procedures. It is more sensitive in predicting the outcome in emergency cases as compared to the elective cases.


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