Evaluación del Apgar quirúrgico en la predicción de complicaciones y muerte perioperatoria: análisis prospectivo en un centro de cuarto nivel de Bogotá / Evaluation of the Apgar surgical score in predicting postoperative complications and mortality: prospective analysis at a fourth
Rev. colomb. cir
;
29(3): 213-221, jul.-set. 2014. graf, tab
Article
in Spanish
| LILACS
| ID: lil-729567
RESUMEN
Introduction /aims:
Surgical APGAR scale is a tool to stratify intraoperative risk. This study evaluates its performance, analyzing the predictive power to determinate postoperative complications and morbidity in a Colombian population.Methods:
We evaluated a prospective cohort of adult patients submitted to urgent or elective general surgical procedures. The cohort was subdivided in two groups of procedures (Minor or intermediate, Group 1; and Major or complex, Group 2). The surgical APGAR was determinate in all cases and a correlation with the probability of complications (SSI, pneumonia, reoperation, mechanical ventilation>48h and death) was established during 30 postoperative days. We calculated the χ² tests (p<0.05) and RR (CI95%) for all levels of APGAR scale and procedures.Results:
488 patients met the inclusion criteria. According to procedures, 31.9% were placed in Group 2, 57.7% urgent and 35.2% laparoscopic. Patients with previous cardiovascular disease (p<0.001), male gender (p<0.05), open surgery (p<0.003), cancer (p<0.001), ASA≥3 (p<0.001), and patients undergoing Group 2 procedures (p<0.001) exhibit a higher probability of complications. Patients with APGAR0-4 developed higher global and discriminate rates of complications (46.1%) OR 13.8 p<0.001). In upper the levels of APGAR scale we identified a progressive reduction of complications and death.Conclusions:
The surgical APGAR scale provides an objective intraoperative stratification of risk in general surgical procedures. Our results are similar to previous reports in the medical literature.ABSTRACT
Introduction /aims:
Surgical APGAR scale is a tool to stratify intraoperative risk. This study evaluates its performance, analyzing the predictive power to determinate postoperative complications and morbidity in a Colombian population.Methods:
We evaluated a prospective cohort of adult patients submitted to urgent or elective general surgical procedures. The cohort was subdivided in two groups of procedures (Minor or intermediate, Group 1; and Major or complex, Group 2). The surgical APGAR was determinate in all cases and a correlation with the probability of complications (SSI, pneumonia, reoperation, mechanical ventilation>48h and death) was established during 30 postoperative days. We calculated the χ² tests (p<0.05) and RR (CI95%) for all levels of APGAR scale and procedures.Results:
488 patients met the inclusion criteria. According to procedures, 31.9% were placed in Group 2, 57.7% urgent and 35.2% laparoscopic. Patients with previous cardiovascular disease (p<0.001), male gender (p<0.05), open surgery (p<0.003), cancer (p<0.001), ASA≥3 (p<0.001), and patients undergoing Group 2 procedures (p<0.001) exhibit a higher probability of complications. Patients with APGAR0-4 developed higher global and discriminate rates of complications (46.1%) OR 13.8 p<0.001). In upper the levels of APGAR scale we identified a progressive reduction of complications and death.Conclusions:
The surgical APGAR scale provides an objective intraoperative stratification of risk in general surgical procedures. Our results are similar to previous reports in the medical literature.
Full text:
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Index:
LILACS (Americas)
Main subject:
Apgar Score
Type of study:
Etiology study
/
Prognostic study
/
Risk factors
Language:
Spanish
Journal:
Rev. colomb. cir
Journal subject:
General Surgery
Year:
2014
Type:
Article
Affiliation country:
Colombia
Institution/Affiliation country:
Pontificia Universidad Javeriana/CO
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