Post-operative morbidity and mortality in pancreatic surgery. The role of surgical Apgar score

作者：La Torre Marco^*; Ramacciato Giovanni; Nigri Giuseppe; Balducci Genoveffa; Cavallini Marco; Rossi Michele; Ziparo Vincenzo

来源：Pancreatology, 2013, 13(2): 175-179.

DOI：10.1016/j.pan.2013.01.011

• Surgical Apgar score
• Pancreatic adenocarcinoma carcinoma
• Pancreatic surgery
• Ampullary carcinoma

Background: Morbidity and mortality rates after pancreatic resection still remain high. The surgical Apgar score (SAS) has been recently introduced as predictive value of perioperative outcomes after pancreatic surgery. Aim of the study was to detect significant parameters affecting post-operative outcomes in pancreatic surgery, and to evaluate the role of SAS in predicting morbidity, pancreatic fistulas and mortality.
Materials and methods: Data were collected from 143 patients who had undergone pancreatic resection for pancreatic and periampullary adenocarcinoma. Pre-operative and intra-operative parameters were statistically analyzed to evaluate their potential prognostic effects.
Results: A low SAS (p = 0.001), hypo-albuminemia (p = 0.003), and the need for blood transfusions (p = 0.05) were significant independent predictors of postoperative morbidity. The SAS was demonstrated to significantly predict major complications (p = 0.001) surgical site infections (p = 0.001) and mortality (p = 0.001).
Conclusion: The SAS provides a simple, immediate, and objective means of measuring patient outcomes in surgery. This score should be used to identify patients at high risk of major complications and death after pancreatic surgery and may be useful to optimize the use of postoperative critical care beds and hospital resources.

• 出版日期2013-4