SynthesisInteractive cardiovascular and thoracic surgery2022
Surgical Apgar score could predict complications after esophagectomy: a systematic review and meta-analysis.
Synthesis in Interactive cardiovascular and thoracic surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Prediction of Morbidity and Mortality After Esophagectomy: A Systematic Review.Annals of surgical oncology · 2024Pooled it
- Improving Nursing Care Models is Beneficial for the Perioperative Phase for Esophageal Cancer Patients.Journal of multidisciplinary healthcare · 2025Article
- MFI-11 in Chinese elderly esophageal cancer patients with postoperative adverse outcomes.BMC geriatrics · 2024Article
- An esophagectomy surgical Apgar score-based nomogram-a risk-based postoperative triage system: a phase II randomised trial.Journal of thoracic disease · 2024Article
- Association between preoperative frailty and surgical Apgar score in abdominal cancer surgery: a secondary analysis of a prospective observational study.JA clinical reports · 2024Article
- Intraoperative risk factors for major complications after oesophagectomy: the surgical Apgar score.Interactive cardiovascular and thoracic surgery · 2022Article
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Authors and funding
8 authors at 5 institutions in 1 country.
Funding
Abstract
objectivesEsophagectomy is the most effective treatment for oesophageal cancer, although the incidence of postoperative complications remains high. Severe major complications, such as intrathoracic anastomotic leakage, are costly and life-threatening to patients. Therefore, early identification of postoperative complications is essential. The surgical Apgar score (SAS) was introduced by Gawande and colleagues to predict major complications after oesophagectomy. Several studies were carried out with inconsistent results.
methodsPubMed, Embase, Web of Science, ClinicalTrials.gov and the Cochrane Library were searched for studies regarding SAS and oesophagectomy. Forest plots were generated using a random-effects model to investigate the actual predictive value of SAS in identifying major complications after oesophagectomy.
resultsNine retrospective cohort studies were finally identified from selected electronic databases. The meta-analysis demonstrated that SAS could forecast the incidence of postoperative complications (odds ratio = 1.82, 95% confidence interval: 1.43-2.33, P < 0.001). Subgroup analysis validated the predictive value of SAS whether as continuous or discrete variables. In addition, a meta-analysis of 4 studies demonstrated that SAS could predict the incidence of pulmonary complications (odds ratio = 2.32, 95% confidence interval: 1.61-3.36, P < 0.001). Significant heterogeneity but no publication bias was found.
conclusionsLower SAS scores could predict the incidence of major morbidities and pulmonary complications after oesophagectomy. Significant heterogeneity limits the reliability of the results, even if publication bias is not observed. More high-quality prospective research should be conducted to verify the findings. PROSPERO registration ID: CRD42020209004.
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