Association between the Surgical Apgar Score and Perioperative Complications after Radical Prostatectomy

被引:11
作者
Orberger, Matthias [1 ]
Palisaar, Jueri [1 ]
Roghmann, Florian [1 ]
Mittelstaedt, Ludger [2 ]
Bischoff, Petra [2 ]
Noldus, Joachim [1 ]
Loeppenberg, Bjoern [1 ]
机构
[1] Ruhr Univ Bochum, Marien Hosp Herne, Dept Urol, Holkeskampring 40, DE-44625 Herne, Germany
[2] Ruhr Univ Bochum, Marien Hosp Herne, Dept Anesthesiol, Herne, Germany
关键词
Prostate cancer; Prostatectomy; Postoperative complications; Postoperative care; RETROPUBIC PROSTATECTOMY; OUTCOMES; SURGERY; RISK;
D O I
10.1159/000450795
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
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. (C) 2016 S. Karger AG, Basel
引用
收藏
页码:61 / 70
页数:10
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共 21 条
  • [11] Complications of pelvic lymphadenectomy in 1,380 patients undergoing radical retropubic prostatectomy between 1993 and 2006
    Musch, Michael
    Klevecka, Virgilijus
    Roggenbuck, Ulla
    Kroepfl, Darko
    [J]. JOURNAL OF UROLOGY, 2008, 179 (03) : 923 - 928
  • [12] da Vinci and Open Radical Prostatectomy: Comparison of Clinical Outcomes and Analysis of Insurance Costs
    Niklas, Christina
    Saar, Matthias
    Berg, Britta
    Steiner, Katrin
    Janssen, Martin
    Siemer, Stefan
    Stoeckle, Michael
    Ohlmann, Carsten-Henning
    [J]. UROLOGIA INTERNATIONALIS, 2016, 96 (03) : 287 - 294
  • [13] Systematic Review and Meta-analysis of Perioperative Outcomes and Complications After Robot-assisted Radical Prostatectomy
    Novara, Giacomo
    Ficarra, Vincenzo
    Rosen, Raymond C.
    Artibani, Walter
    Costello, Anthony
    Eastham, James A.
    Graefen, Markus
    Guazzoni, Giorgio
    Shariat, Shahrokh F.
    Stolzenburg, Jens-Uwe
    Van Poppel, Hendrik
    Zattoni, Filiberto
    Montorsi, Francesco
    Mottrie, Alexandre
    Wilson, Timothy G.
    [J]. EUROPEAN UROLOGY, 2012, 62 (03) : 431 - 452
  • [14] Assessment of the Surgical Apgar Score in a Swedish setting
    Ohlsson, H.
    Winso, O.
    [J]. ACTA ANAESTHESIOLOGICA SCANDINAVICA, 2011, 55 (05) : 524 - 529
  • [15] Surgical Apgar Outcome Score: Perioperative Risk Assessment for Radical Cystectomy
    Prasad, Sandip M.
    Ferreria, Marcos
    Berry, Alexander M.
    Lipsitz, Stuart R.
    Richie, Jerome P.
    Gawande, Atul A.
    Hu, Jim C.
    [J]. JOURNAL OF UROLOGY, 2009, 181 (03) : 1046 - 1052
  • [16] Comprehensive Standardized Report of Complications of Retropubic and Laparoscopic Radical Prostatectomy
    Rabbani, Farhang
    Yunis, Luis Herran
    Pinochet, Rodrigo
    Nogueira, Lucas
    Vora, Kinjal C.
    Eastham, James A.
    Guillonneau, Bertrand
    Laudone, Vincent
    Scardino, Peter T.
    Touijer, Karim
    [J]. EUROPEAN UROLOGY, 2010, 57 (03) : 371 - 386
  • [17] Utility of the Surgical Apgar Score Validation in 4119 Patients
    Regenbogen, Scott E.
    Ehrenfeld, Jesse M.
    Lipsitz, Stuart R.
    Greenberg, Caprice C.
    Hutter, Matthew M.
    Gawande, Atul A.
    [J]. ARCHIVES OF SURGERY, 2009, 144 (01) : 30 - 36
  • [18] Expansion of the Surgical Apgar Score across All Surgical Subspecialties as a Means to Predict Postoperative Mortality
    Reynolds, Paul Q.
    Sanders, Neal W.
    Schildcrout, Jonathan S.
    Mercaldo, Nathaniel D.
    St Jacques, Paul J.
    [J]. ANESTHESIOLOGY, 2011, 114 (06) : 1305 - 1312
  • [19] Standardized assessment of complications in a contemporary series of European patients undergoing radical cystectomy
    Roghmann, Florian
    Quoc-Dien Trinh
    Braun, Katharina
    von Bodman, Christian
    Brock, Marko
    Noldus, Joachim
    Palisaar, Jueri
    [J]. INTERNATIONAL JOURNAL OF UROLOGY, 2014, 21 (02) : 143 - 149
  • [20] Identification and reduction of surgical error using simulation
    Satava, RM
    [J]. MINIMALLY INVASIVE THERAPY & ALLIED TECHNOLOGIES, 2005, 14 (4-5) : 257 - 261