PS01.137: CLINICAL IMPACT OF SURGICAL APGAR SCORE IN PREDICTING POSTOPERATIVE COMPLICATIONS AND LONG-TERM PROGNOSIS AFTER ESOPHAGECTOMY. (14th September 2018)

• Record Type: Journal Article
• Authors: Ishida, Sonoko; Nakagawa, Akio; Nakamura, Tetsu; Oshikiri, Taro; Hasegawa, Hiroshi; Yamamoto, Masashi; Kanaji, Shingo; Matsuda, Yoshiko; Yamashita, Kimihiro; Matsuda, Takeru; Sumi, Yasuo; Suzuki, Satoshi; Kakeji, Yoshihiro
• Is Part Of: Diseases of the esophagus. Volume 31(2018)Supplement 1
• Page Start: 88
• Page End: 89
• Publication Date: 2018-09-14
• Subjects: êsophagectomy -- Surgical Apgar Score -- long-term prognosis; Esophagus -- Diseases -- Periodicals; 616.32
• DOI: 10.1093/dote/doy089.PS01.137
• Languages: English
• ISSNs: 1120-8694

Abstract

Abstract: Background: Surgical Apgar Score (SAS) is a risk calculator, and is known to predict postoperative complications after surgery. Because it applies three intraoperative parameters, namely estimated blood loss, lowest mean arterial pressure, and lowest heart rate, actual surgical stress is reflected to its scoring system and many studies have reported its usefulness. And in recent years, close relationship between postoperative complications and long-term prognosis has been reported, but there are almost no studies about the relevance between risk calculator of complications and long-term prognosis. Methods: A total of 400 patients who underwent esophagectomy for esophageal cancer between January 2007 and January 2017 at our institution were included in this study. Clinicopathological and intraoperative data to calculate SAS were collected from medical records, and a 10-point scoring system based on the original method was used to assign points. Complications classified as Clavien-Dindo grade III or higher were defined as postoperative complications. The relationship between SAS and postoperative complications and long-term prognosis was investigated. Results: Postoperative complications occurred in 145 cases (36%). From ROC analysis, we set the SAS cut-off value to 5 points in this study. There were no significant differences in patient's background between the group of SAS ≤ 5 and > 5. Multivariate logistic regression analysis showed that hypertension ( P = 0.049) and SAS ≤ 5 ( P < 0.0001) were significant predictive factors for postoperative complications. In the prognostic analysis, log-rank analysis showed that patients with SAS ≤ 5 had a significantly poorer prognosis than those with SAS > 5 ( P = 0.043), especially in clinical stage 2 or higher esophageal cancer ( P = 0.027). In the multivariate analysis, SAS ≤ 5 was revealed to be a significantly poor prognostic factor in clinical stage 2 or higher esophageal cancer ( P = 0.029). Conclusion: The Surgical Apgar Score can predict postoperative complications, and is also useful to predict long-term prognosis after esophagectomy for esophageal cancer. Disclosure: All authors have declared no conflicts of interest.