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Utility of the Surgical Apgar Score—Invited Critique
Darrell A. Campbell Jr, MD
Arch Surg. 2009;144(1):37.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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Surgeons smile when a cardiologist during a preoperative consultation suggests that we "avoid intraoperative hypoxia and hypotension." We know these general aspects of care are important, but little attention has been devoted to quantifying how important they are and linking that information to the related clinical consequences. Regenbogen et al have used multivariable logistic regression analysis to identify 3 factors independently associated with poor outcomes. Now cardiologists might suggest a more informed strategy—"avoid hypotension, blood loss, and bradycardia."
I disagree with the authors' assertion that the Surgical Apgar Score "does not allow for comparison of quality among institutions." However, the score requires a little tweaking for this application. If one stratifies patient populations by preoperative risk Current Procedural Terminology code, or both, one might find some real differences in Surgical Apgar Score from institution to institution within these categories. These differences could relate to surgical . . . [Full Text of this Article]
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Utility of the Surgical Apgar Score: Validation in 4119 Patients
Scott E. Regenbogen, Jesse M. Ehrenfeld, Stuart R. Lipsitz, Caprice C. Greenberg, Matthew M. Hutter, and Atul A. Gawande
Arch Surg. 2009;144(1):30-36.
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