Abstract

Context: Postoperative complications following laparotomy remain a major cause of morbidity and mortality. Accurate intraoperative risk assessment tools are essential for early identification of high-risk patients. The Surgical Apgar Score (SAS) is a simple and objective scoring system based on intraoperative parameters including estimated blood loss, lowest mean arterial pressure, and lowest heart rate. Aim: To evaluate the utility of the Surgical Apgar Score in predicting postoperative morbidity and mortality in patients undergoing laparotomy. Study and Design: A prospective observational study was conducted at a tertiary care teaching hospital in India. Materials and Methods: A total of 130 patients undergoing laparotomy were included. The Surgical Apgar Score was calculated intraoperatively using lowest heart rate, lowest mean arterial pressure, and estimated blood loss. Patients were categorized into three risk groups: high risk (SAS 0–4), moderate risk (SAS 5–6), and low risk (SAS 7–10). Patients were followed for 30 days postoperatively to assess complications and mortality. Statistical Analysis Used: Statistical analysis was performed using Chi-square test. Results: The association between low Surgical Apgar Score and incidence of postoperative complications and mortality was statistically significant (p value <0.0001). Conclusion: The Surgical Apgar Score is a simple, reliable, and effective intraoperative tool for predicting postoperative morbidity and mortality following laparotomy. Its routine use can help in early risk stratification, better postoperative monitoring, and optimal allocation of critical care resources. Key Messages: 1. Surgical Apgar Score is a simple intraoperative tool for early postoperative risk stratification. 2. Lower SAS is strongly associated with major complications and mortality after laparotomy. 3. Routine use of SAS can improve postoperative monitoring and ICU triage.

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