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Volume 98, Issue 1
January 2017
Research Articles| December 02 2016
Subject Area: Further Areas
Matthias Orberger;
Matthias Orberger
aDepartment of Urology, and
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Jüri Palisaar;
Jüri Palisaar
aDepartment of Urology, and
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Florian Roghmann;
Florian Roghmann
aDepartment of Urology, and
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Ludger Mittelstädt;
Ludger Mittelstädt
bDepartment of Anesthesiology, Ruhr-University Bochum, Marien Hospital Herne, Herne, Germany
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Petra Bischoff;
Petra Bischoff
bDepartment of Anesthesiology, Ruhr-University Bochum, Marien Hospital Herne, Herne, Germany
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Joachim Noldus;
Joachim Noldus
aDepartment of Urology, and
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Björn Löppenberg
aDepartment of Urology, and
bjoern.loeppenberg@elisabethgruppe.de
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bjoern.loeppenberg@elisabethgruppe.de
Urol Int (2017) 98 (1): 61–70.
Article history
Received:
July 05 2016
Accepted:
September 12 2016
Published Online:
December 02 2016
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Citation
Matthias Orberger, Jüri Palisaar, Florian Roghmann, Ludger Mittelstädt, Petra Bischoff, Joachim Noldus, Björn Löppenberg; Association between the Surgical Apgar Score and Perioperative Complications after Radical Prostatectomy. Urol Int 25 January 2017; 98 (1): 61–70. https://doi.org/10.1159/000450795
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Abstract
Objective: To evaluate whether the Surgical Apgar Score (SAS) can identify patients who are at risk for perioperative adverse events (PAE) following radical prostatectomy for prostate cancer. Patients and Methods: At a single academic institution, 994 patients undergoing radical prostatectomy between 2010 and 2013 were analyzed retrospectively. The SAS was calculated from anesthesia records, evaluated to predict PAE within a 30-day time period postoperatively; these events were classified according to standardized classification systems. Results: We observed adverse events in 45.4% (451/994) of patients with a total of 694 events. Overall, 41% (408/994) had low- and 9.9% (98/994) had high-grade events. A lower SAS was identified as an independent predictor of any (p < 0.001) and low-grade adverse events (p = 0.001) for those patients who had undergone open retropubic radical prostatectomy (ORRP). Each 1-point increment resulted in a 24% decrease in the odds of any (95% CI 0.66-0.88) and a 21% decrease in the odds of a low-grade (95% CI 0.69-0.91) event. Adverse events of robot-assisted prostatectomy were not associated with the SAS. Conclusions: Lower SAS values indicate patients at risk for adverse events after ORRP. The SAS might serve as one variable for outcome assessment, reflecting the challenge of mutual surgical and anesthesiology procedure management.
Keywords:
Prostate cancer, Postoperative care, Prostatectomy, Postoperative complications
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© 2016 S. Karger AG, Basel
2016
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