Does the Surgical Apgar Score measure intraoperative performance?
OBJECTIVE: To evaluate whether Surgical Apgar Scores measure the relationship between intraoperative care and surgical outcomes. SUMMARY BACKGROUND DATA: With preoperative risk-adjustment now well-developed, the role of intraoperative performance in surgical outcomes may be considered. We previously derived and validated a 10-point Surgical Apgar Score–based on intraoperative blood loss, heart rate, and blood pressure–that effectively predicts major postoperative complications within 30 days of general and vascular surgery. This study evaluates whether the predictive value of this score comes solely from patients’ preoperative risk or also measures care in the operating room. METHODS: Among a systematic sample of 4119 general and vascular surgery patients at a major academic hospital, we constructed a detailed risk-prediction model including 27 patient-comorbidity and procedure-complexity variables, and computed patients’ propensity to suffer a major postoperative complication. We ev
