Surgical Apgar Score can help predict postoperative cardiopulmonary complication and reoperation in lung cancer resection

Abstract

Abstract Background Bleeding due to lung resection increases the risk of cardiopulmonary complications and hospital stay. Surgical massive bleeding is associated with a high rate of mortality. In this study, our aim is to determine the effectiveness of Surgical Apgar Score in predicting complications and reoperation in the short term. Peroperative data of 405 patients aged 18–82 who underwent lung resection (pneumonectomy, lobectomy, wedge) and were operated consecutively were recorded. Results Pulmonary complication developed in 38 (9.4%) of the patients, cardiac complication in 104 (25.7%), acute kidney failure in 8 (1.9%), and cerebrovascular accident in 1 (0.2%). Reoperation was performed in 24 (5.9%) patients due to bleeding. The Surgical Apgar Score was found to predict postoperative complications well for a value of < 6 (area under the curve = 0.745, 95%CI 0.710–0.7770, p < 0.001). When Surgical Apgar Score were evaluated together with receiver operating characteristic, the ability of Surgical Apgar Score to predict reoperation was found to be statistically significant (area under the curve = 0.777, 95%CI 0.671–0.883, p < 0.001. Accordingly, age, resection type, blood loss, heart rate, SAS score, intraoperative blood transfusion, and postoperative blood transfusion were independent risk factors affecting the development of complications. It was determined that the only independent risk factor affecting the development of mortality was postoperative blood transfusion. It was determined that the independent risk factors affecting ICU development were resection type, blood loss, SAS score, and postoperative blood transfusion. Conclusion In our study, the Surgical Apgar Scoring System was found to be sufficient in predicting cardiac and respiratory complications. Patients with a low postoperative Surgical Apgar Score should be followed carefully in terms of postoperative complications and reoperation. Surgical Apgar Score can be a useful scoring method in predicting the prognosis of patients who underwent lung cancer resection in the postoperative period.