ArticleJournal of thoracic disease2016
The value of esophagectomy surgical apgar score (eSAS) in predicting the risk of major morbidity after open esophagectomy.
Article in Journal of thoracic disease, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Predictive role of surgical Apgar score for postoperative complications and survival in patients receiving esophagectomy: a meta-analysis.Journal of cardiothoracic surgery · 2026Pooled it
- Surgical Apgar score could predict complications after esophagectomy: a systematic review and meta-analysis.Interactive cardiovascular and thoracic surgery · 2022Pooled it
- Trial
- Drinkable gene therapy foam for the treatment of constrictive esophageal carcinoma.Gene therapy · 2026Article
- Optimizing Perioperative Care in Esophageal Surgery: The EUropean PErioperative MEdical Networking (EUPEMEN) Collaborative for Esophagectomy.Diseases (Basel, Switzerland) · 2025Article
- Endoscopic submucosal dissection (ESD) outcomes in T1B esophageal cancer: a retrospective study.Surgical endoscopy · 2024Article
- Combined and intraoperative risk modelling for oesophagectomy: A systematic review.World journal of gastrointestinal surgery · 2023Article
- Implementation of the Surgical Apgar Score in Laboratory Animal Science: A Showcase Pilot Study in a Porcine Model and a Review of the Literature.European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes · 2023Review
- Article
- Neoadjuvant therapy does not adversely affect the short-term outcome of critically ill cancer patients who underwent surgery.Translational cancer research · 2020Article
- A low surgical Apgar score is a predictor of anastomotic leakage after transthoracic esophagectomy, but not a prognostic factor.Esophagus : official journal of the Japan Esophageal Society · 2019Observational
- The Reliability of Surgical Apgar Score in Predicting Immediate and Late Postoperative Morbidity and Mortality: A Narrative Review.Rambam Maimonides medical journal · 2018Review
- Comparison of short-term outcomes and three yearsurvival between total minimally invasive McKeown and dual-incision esophagectomy.Thoracic cancer · 2017Article
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8 authors.
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Abstract
backgroundRecently, surgical apgar score (SAS) has been reported to be strongly associated with major morbidity after major abdominal surgery. The aim of this study was to assess the value of esophagectomy SAS (eSAS) in predicting the risk of major morbidity after open esophagectomy in a high volume cancer center.
methodsThe data of all patients who admitted to intensive care unit (ICU) after open esophagectomy at Cancer Hospital of Chinese Academy of Medical Sciences & Peking Union Medical College from September 2008 through August 2010 was retrospectively collected and reviewed. Preoperative and perioperative variables were recorded and compared. The eSAS was calculated as the sum of the points of EBL, lowest MAP and lowest HR for each patient. Patients were divided into high-risk (below the cutoff) and low-risk (above the cutoff) eSAS groups according to the cutoff score with optimal accuracy of eSAS for major morbidity. Univariable and multivariable regression analysis were used to define risk factors of the occurrence of major morbidity.
resultsOf 189 patients, 110 patients developed major morbidities (58.2%) and 30-day operative mortality was 5.8% (11/189). There were 156 high risk patients (eSAS ≤7) and 33 low risk (eSAS >7) patients. Univariable analysis demonstrated that forced expiratory volume in one second of predicted (FEV1%) ≤78% (44% vs. 61%, P=0.024), McKeown approach (22.7% vs. 7.6%, P=0.011), duration of operation longer than 230 minutes, intraoperative estimated blood loss (347±263 vs. 500±510 mL, P=0.015) and eSAS ≤7 (62.2% vs. 90.0%, P=0.001) were predictive of major morbidity. Multivariable analysis demonstrated that FEV1% ≤78% (OR, 2.493; 95% CI, 1.279-4.858, P=0.007) and eSAS ≤7 (OR, 2.810; 95% CI, 1.105-7.144; P=0.030) were independent predictors of major morbidity after esophagectomy. Compared with patients who had eSAS >7, patients who had eSAS ≤7 had longer hospital length of stay (25.39±14.36 vs. 32.22±22.66 days, P=0.030). However, there were no significant differences in ICU length of stay, duration of mechanical ventilation, ICU death, 30-day death rate and in-hospital death rate between high risk and low risk patients.
conclusionsThe eSAS score is predictive of major morbidity, and lower eSAS is associated with longer hospital length of stay in esophageal cancer patients after open esophagectomy.
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