Journal Article

The surgical Apgar score predicts postoperative complications and the survival in lung cancer patients

Saito, Tomohito, Matsui, Hiroshi, Hagihira, Satoshi, Taniguchi, Yohei, Murakawa, Tomohiro, Maru, Natsumi, Utsumi, Takahiro, Hino, Haruaki

2023

Overview

Purpose The surgical Apgar score (SAS)—calculated using the intraoperative variables estimated blood loss, lowest heart rate, and lowest mean systolic pressure—is associated with mortality in cancer surgery. We investigated the utility of the SAS in patients with lung cancer undergoing surgery. Methods We retrospectively analyzed the data of 691 patients who underwent surgery for primary lung cancer between 2015 and 2019 in a single institute and analyzed the impact of the SAS. Results Of the 691 patients, 138 (20%), 57 (8.2%), and 7 (1.0%) had postoperative complications of all grades, grades ≥ III, and grade V, respectively, according to the Clavien–Dindo classification. The C-index for postoperative complications of grades ≥ III was 0.605. A lower score (0–5 points) (odds ratio 3.09 against 8–10 points, P  = 0.04) and a lower percentage of vital capacity (odds ratio 0.97, P  = 0.04) were independent negative risk factors for major postoperative complications. Patients with a lower score (0–5 points) had poor 5-year overall and cancer-specific survival rates (60.1% and 72.3%, respectively; P  < 0.05 for both). Conclusions The surgical Apgar score predicted postoperative complications and the long-term survival. Surgeons may improve surgical results using the SAS.

• Publisher: Springer Nature Singapore,Springer Nature B.V
• Subject: Antigens / Apgar score / Blood pressure / Body mass index / Cancer surgery / Cancer therapies / Chemotherapy / Comorbidity / Heart rate / Histology / Lung cancer / Medicine / Medicine & Public Health / Original Article / Pathology / Postoperative period / Regression analysis / Surgery / Surgical Oncology / Variables