Surgical Apgar score as a predictor of outcomes in patients following laparotomy at Mulago National Referral Hospital, Uganda: a prospective cohort study

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dc.contributor.authorChan Onen, Bruno
dc.contributor.authorSemulimi, Andrew Weil
dc.contributor.authorBongomin, Felix
dc.contributor.authorOlum, Ronald
dc.contributor.authorKurigamba, Gideon
dc.contributor.authorMbiine, Ronald
dc.contributor.authorKituuka, Olivia
dc.date.accessioned2023-01-24T11:29:59Z
dc.date.available2023-01-24T11:29:59Z
dc.date.issued2022
dc.description.abstractPostoperative complications and mortality following laparotomy have remained high worldwide. Early postoperative risk stratification is essential to improve outcomes and clinical care. The surgical Apgar score (SAS) is a simple and objective bedside prediction tool that can guide a surgeon’s postoperative decision making. The objective of this study was to evaluate the performance of SAS in predicting outcomes in patients undergoing laparotomy at Mulago hospital. Method: A prospective observational study was conducted among eligible adult patients undergoing laparotomy at Mulago hospital and followed up for 4 months. We collected data on the patient’s preoperative and intraoperative characteristics. Using the data generated, SAS was calculated, and patients were classified into 3 groups namely: low (8–10), medium (5–7), and high (0–4). Primary outcomes were in-hospital major complications and mortality. Data was presented as proportions or mean (standard deviation) or median (interquartile range) as appropriate. We used inferential statistics to determine the association between the SAS and the primary outcomes while the SAS discriminatory ability was determined from the receiver-operating curve (ROC) analysis. Results: Of the 151 participants recruited, 103 (68.2%) were male and the mean age was 40.6 ± 15. Overall postoperative in-hospital major complications and mortality rates were 24.2% and 10.6%, respectively. The participants with a high SAS category had an18.4 times risk (95% CI, 1.9–177, p = 0.012) of developing major complications, while those in medium SAS category had 3.9 times risk (95% CI, 1.01–15.26, p = 0.048) of dying. SAS had a fair discriminatory ability for in-hospital major complications and mortality with the area under the curve of 0.75 and 0.77, respectively. The sensitivity and specificity of SAS ≤ 6 for major complications were 60.5% and 81.14% respectively, and for death 54.8% and 81.3%, respectively. Conclusion: SAS of ≤ 6 is associated with an increased risk of major complications and/or mortality. SAS has a high specificity with an overall fair discriminatory aen_US
dc.identifier.citationOnen, B. C., Semulimi, A. W., Bongomin, F., Olum, R., Kurigamba, G., Mbiine, R., & Kituuka, O. (2022). Surgical Apgar score as a predictor of outcomes in patients following laparotomy at Mulago National Referral Hospital, Uganda: a prospective cohort study. BMC surgery, 22(1), 1-12. https://doi.org/10.1186/s12893-022-01883-7en_US
dc.identifier.urihttps://doi.org/10.1186/s12893-022-01883-7
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/7152
dc.language.isoenen_US
dc.publisherBMC surgeryen_US
dc.subjectSurgical Apgar scoreen_US
dc.subjectLaparotomyen_US
dc.subjectMajor complicationsen_US
dc.titleSurgical Apgar score as a predictor of outcomes in patients following laparotomy at Mulago National Referral Hospital, Uganda: a prospective cohort studyen_US
dc.typeArticleen_US
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