E1 |
Assifi et al.66 Assifi MM, Lindenmeyer J, Leiby BE, Grunwald Z, Rosato EL, Kennedy EP, et al. Surgical Apgar score predicts perioperative morbidity in patients undergoing pancreaticoduodenectomy at a high-volume center. J Gastrointest Surg 2011;16(2):275-81. https://doi.org/10.1007/s11605-011-1733-1 https://doi.org/10.1007/s11605-011-1733-...
|
Determine whether SAS predicts perioperative morbidity and mortality. |
553 patients who underwent successful pancreaticoduodenectomy from 2000 to December 2010 were examined. Postoperative complications were classified using the Clavien scale and the SAS with a determined range of 0-10. |
Statistical analysis determined that SAS was a predictor of grade 2 or higher complications (p < 0.0001), significant morbidity (p = 0.01) and pancreatic fistula (p = 0.04) but not mortality (p = 0.20). |
E2 |
Aoyama et al.77 Aoyama T, Kazama K, Murakawa M, Atsumi Y, Shiozawa M, Kobayashi S, et al. The surgical Apgar score is an independent prognostic factor in patients with pancreatic cancer undergoing pancreatoduodenectomy followed by adjuvant chemotherapy. Anticancer Res [periódicos na Internet] 2016 [acesso em 25 Fev 2023];36(5):2497-503. Disponível em: https://ar.iiarjournals.org/content/36/5/2497.long https://ar.iiarjournals.org/content/36/5...
|
To investigate the effects of SAS on the survival of patients with pancreatic cancer undergoing pancreaticoduodenectomy followed by adjuvant chemotherapy. |
This study included 103 patients who underwent curative surgical treatment for pancreatic cancer from 2005 to 2014. Patients with SAS of 0-4 were classified as low risk, while those with SAS of 5-10 were classified as high risk. Risk factors and recurrence-free survival were identified. |
The recurrence-free survival rates at 3 and 5 years after surgery were 23 and 14.4%, respectively, in the low SAS group and 32.3 and 21.4%, respectively, in the high SAS group, which obtained a significant difference (p = 0.039). |
E3
|
La Torre et al. 88 La Torre M, Ramacciato G, Nigri G, Balducci G, Cavallini M, Rossi M, et al. Post-operative morbidity and mortality in pancreatic surgery. The role of surgical Apgar score. Pancreatology 2013;13(2):175-9. https://doi.org/10.1016/j.pan.2013.01.011 https://doi.org/10.1016/j.pan.2013.01.01...
|
To detect significant parameters that affect postoperative outcomes in pancreatic surgery and evaluate the role of SAS in predicting morbidity, pancreatic fistulas and mortality. |
Data were collected from 143 patients who underwent pancreatic resection for pancreatic and periampullary adenocarcinoma. Preoperative and intraoperative parameters were statistically analyzed to evaluate their potential prognostic effects. |
Low SAS, hypoalbuminemia, and the need for blood transfusions were significant independent predictors of postoperative morbidity. SAS has been shown to significantly predict major complications, surgical site infections, and mortality. |
E4 |
Pearson et al.44 Pearson, ACS, Subramanian A, Schroeder DR, Findlay JY. Adapting the surgical Apgar score for perioperative outcome prediction in liver transplantation: a retrospective study. Transplant Direct 2017;3(11):e221. https://doi.org/10.1097/TXD.0000000000000739 https://doi.org/10.1097/TXD.000000000000...
|
Propose a change in the SAS for patients undergoing liver transplantation. |
The SAS-LT was developed using a retrospective cohort of consecutive liver transplants from July 2007 to November 2013. Its predictive ability for early postoperative outcomes was compared to the model for end-stage liver disease (MELD). Disease Scores, Sequential Assessment of Organ Failure, and Assessment of Acute Physiology and Chronic Health III Using Multivariable Logistic Regression and Receiver Operating Characteristics Analysis. |
Of 628 transplants, death or severe perioperative morbidity occurred in 105 (16.7%). The SAS-LT had similar predictive ability for acute physiology and chronic health assessment III, model for end-stage liver disease, and sequential organ failure assessment scores. |
E5 |
Mitsiev et al.99 Mitsiev I, Rubio K, Ranvir VP, Yu D, Palanisamy AP, Chavin KD, et al. Combining ALT/AST values withsurgical APGAR score improves prediction of major complications after hepatectomy. J Surg Res 2021;4(4):656-70. https://doi.org/10.26502/jsr.10020179 https://doi.org/10.26502/jsr.10020179...
|
Define a classification of simple complications after hepatectomy. |
119 patients undergoing liver resection were included. Postoperative complications were determined at follow-up based on the Centers for Disease Control. Clinicopathological factors were used to calculate SAS. Circulating levels of liver injury markers were analyzed as critical elements in postsurgical complications. |
SAS was reduced in patients with complications compared to those without complications. The best cutoff value for SAS was ≤ 6/≥ 7, at which sensitivity and specificity were maximum. ALT/AST levels significantly differed in the group with 9-10 SAS points (p = 0.01 and 0.02). In conclusion, SAS provides accurate risk stratification for major postsurgical complications after hepatectomy and may help improve overall patient outcomes. |
E6 |
Tomimaru et al.1010 Tomimaru Y, Takada K, Shirakawa T, Noguchi K, Morita S, Imamura H, et al. Surgical Apgar score forpredicting complications after hepatectomy for hepatocellular carcinoma. J Surg Res 2018;222:108-14.https://doi.org/10.1016/j.jss.2017.10.013 https://doi.org/10.1016/j.jss.2017.10.01...
|
Use SAS in patients undergoing hepatectomy for HCC. |
This study included 158 patients who underwent hepatectomy for HCC. The association between SAS and postoperative complications was examined. Patients had postoperative morbidities classified as Clavien-Dindo grade II or higher. |
Postoperative complications occurred in 28 (17.7%) of the 158 patients. The SAS was significantly lower in cases with complications than those without. Multivariate analysis revealed that postoperative complications significantly correlated with SAS. |