Surgical Apgar Score predicts postoperative complications in traumatic brain injury

Abstract

Background: Predicting complications in neurotrauma patients by using an effective scoring system can reduce morbidity and mortality while facilitating objective clinical decision making during recovery. Compared to existing morbidity and mortality predictive scores, the Surgical Apgar Score (SAS) is simple and effective. We carried out this study to determine the utility of SAS in predicting postoperative complications in neurotrauma patients.

Methods: A prospective study was carried out at the Kenyatta National Hospital. The SAS was derived using intra-operative lowest mean arterial pressure, lowest heart rate and total blood loss for each patient. Major complications were determined during the thirty day post operative period.

Results: Two hundred and one patients were reviewed. One hundred and sixteen (56%) of the patients developed major complications. The mean SAS for patients without complications was 7.04 while for patients with complications was 4.80. SAS was found to have a strong correlation with occurrence of major complication during the 30 day post surgery period.

Conclusion: The SAS is useful in predicting complications and mortality following surgery in patients with traumatic brain injury. The score is recommended in triaging post operative patients and as a guide for patient referral.