Predictability of surgical apgar score on short term outcomes of laparotomies at the university teaching hospital in Lusaka, Zambia
Date
2019
Authors
Michelo, Felix.M M
Journal Title
Journal ISSN
Volume Title
Publisher
The University of Zambia
Abstract
The Surgical Apgar Score (SAS) is a very easy and objective tool for triaging patients postsurgery.
It can be used as an assessment tool for performance of hospitals, units or individual
surgeons. However, not much research has been done to assess its utility in resource limited
settings like Zambia. This study was undertaken to assess the predictability of SAS in
laparotomy patients at UTH in Lusaka, Zambia.This was a prospective cohort study. A total of
50 patients were recruited, their intraoperative data collected and SAS calculated. The patients
were followed up for 30 days. The primary end point was incidence of any major complication
and/or death as defined by the Dindo-Clavien classification. Two out of the 50 patients enrolled
were lost to follow up, leaving a total of 48 patients. Age ranged from 17 to 89 years with mean
age of 38.8 years (SD 17 years). Out of the patients enrolled, 79 percent were male with 73
percent of operations being emergencies. Intestinal obstruction was the most common diagnosis
accounting for 31.3 percent followed by viscus perforation. Of the patients enrolled, 58.3 percent
had no complications. Overall, complications rate was 41.3 percent which was consistent with
published literature. Deep surgical site infection was the most common complications at 12.5
percent. Patients who did not develop complications had a significantly higher SAS compared to
patients who did (p<0.001). Mortality rate in the high risk group was higher than predicted by
SAS (p=0.23). Period of operation and gender did not significantly affect the SAS of patients (p
values =0.45 and 0.28 respectively).
This study confirms that SAS is adequate at predicting outcome in laparotomy patients in
resource limited settings like UTH.
Key words; laparotomy, postoperative complications, Surgical Apgar score
Description
Thesis
Keywords
Abdomen--Surgery--Zambia , Laparotomy--Zambia