Application of the surgical Apgar score (SAS) to predict postoperative complication(s) in the patients with traumatic brain injury: Study of single center in Indonesia

Muhammad Z. Arifin; Andi N. Sendjaja; Ahmad Faried

doi:10.3889/oamjms.2021.5843

Authors

Muhammad Z. Arifin Department of Neurosurgery, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia
Andi N. Sendjaja Department of Neurosurgery, BP Batam Hospital, Batam, Indonesia
Ahmad Faried Department of Neurosurgery, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia https://orcid.org/0000-0003-2967-8125

DOI:

https://doi.org/10.3889/oamjms.2021.5843

Keywords:

Traumatic brain injury, Surgical Apgar Score (SAS), Intraoperative predictor

Abstract

BACKGROUND: Traumatic brain injury (TBI) is a major health problem. Surgery in patients with TBI is associated with a high rate of complications and mortality. The surgical Apgar score (SAS) is a simple quantitative and objective intraoperative tool for predicting major post-operative complications including mortality.

AIM: Our study aimed to analyze the use of SAS as a predictor of post-operative complications in patients with TBI.

METHODS: This was a prospective cohort study at our center in RSHS, Bandung, Indonesia, throughout 2017 by assessing SAS based on calculating intraoperative estimated blood loss, lowest mean arterial pressure, and lowest heart rate for each patient with TBI, as well as the incident complications within 30 days post-operative were recorded.

RESULTS: One hundred fifty-six patients with TBI underwent surgery in 2017 with 123 patients met the inclusion criteria. Among those, 63 patients (51.2%) developed major complications with 8 patients (12.7%) experienced death. The mean SAS for patients without complication was 8.20, whereas for patients with complication was 6.11. SAS has an inverse correlation (r = –0.754) and an association (p < 0.005) with post-operative complication (s) within 30 days.

CONCLUSIONS: The SAS has an inverse correlation and an association with incidence of complications thus potentially useful as an intraoperative predictor for incident complications within 30 days post-operative care in patients with TBI.

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