Perioperative medicine & outcomes
Improved Re-estimation of Perioperative Cardiac Risk Using the Surgical Apgar Score: A Retrospective Cohort Study
Authors' conclusion
When combined with a validated preoperative risk index, the SAS improved the accuracy of cardiac risk assessment for noncardiac surgery.
Study context
- Population
- Adults (≥18 years) undergoing elective noncardiac surgery at a quaternary care hospital in Canada, 2009–2014607 (3.6%) with myocardial injury
- Participants
- 16,835 adults
- Exposure
- Revised Cardiac Risk Index plus Surgical Apgar Score (SAS) vs Revised Cardiac Risk Index alone
- Outcome
- Postoperative acute myocardial injury
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Prediction of postoperative acute myocardial injury
Integrated discrimination improvement
2.0%
95% CI 1.5%–2.4%
RCRI + SAS vs RCRI
Continuous net reclassification index
54%
95% CI 46%–62%
RCRI + SAS vs RCRI
RCRI
0.68
95% CI 0.65–0.70
c-index
RCRI + SAS
0.75
95% CI 0.73–0.77
c-index
Observational data: associations, not effects.
Original publication
Improved Re-estimation of Perioperative Cardiac Risk Using the Surgical Apgar Score: A Retrospective Cohort Study. Ann Surg. Published 8 July 2022. doi:10.
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