Background and Goal of Study:The Surgical Apgar Score (SAS) has been considered as a good independent predictor of major postoperative complications and mortality in the first 30 days in different types of surgeries.

This scale has already been validated in different orthopedic surgical procedures and there are several studies that highlight its usefulness in hip fracture surgery. Patients with a SAS ≤4 are 14.4 times more likely to suffer major complications in the first 30 days compared to those with a SAS ≥5.

Our goal with this study was to evaluate the risk in our population using the Surgical Apgar Score.

Materials and Methods: An observational study was carried out analyzing all the hip fracture surgeries performed in our hospital over a month. 32 consecutive patients were selected.

SAS was calculated prospectively from intraoperative data. The appearance of major complications and death in the first 30 days was recorded from the clinical evolution. Among these complications were: anemia requiring transfusion, acute myocardial infarction, decompensation of heart failure, cardiorespiratory arrest, need for reoperation or re-entry in resuscitation, need for vasoactive support drugs or mechanical ventilation, acute renal failure, stroke, pulmonary embolism or DVT, sepsis, pneumonia, fever or urinary tract infection, as well as delirium without a history of previous cognitive disorders.

Data analysis was performed with the IBM SPSS Statistics. We carry out a comparison of the means through the T-Student.

Results and Discussion: We analyzed a total of 32 patients (78.1% were women). The mean age was 85.34 years (SD: 7.19). The mean os SAS in the sample was 6.91 (SD: 1.38). The incidence of major complications in the first 30 days was 68.8%.

We analyzed the relationship of SAS with the appearance of major complications in the first 30 days as a whole, as well as each of them individually.  In the case of delirium, lower SAS could be found in those who suffered it (mean of 6.00; SD: 1.00), than in those who did not (7.16; SD: 1.38). (p=0.047). We could not find statistical significance that would support that worse scores in SAS were related to a higher incidence of other complications. 

Conclusion: Surgical Apgar Score could become a very useful tool when it comes to immediately identify patients with a higher risk stratification and thus be able to receive post-intensive intensive care and closer attention both during as after the hospital stay.

10 / Application of the Surgical Apgar Score for the prediction of major complications in hip fracture surgery.