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Surgical Apgar Score for Identifying Patients Who May Need Intensive Care After Emergency Abdominal Surgery (SAS-ICU)

6 septembre 2026 mis à jour par: King Edward Medical University

Surgical Apgar Score Predicts ICU Admission After Emergency General Surgery Laparotomy

This prospective observational study will evaluate whether the Surgical Apgar Score can help identify patients who require direct admission to the intensive care unit after emergency abdominal surgery. The study will include patients aged over 12 and under 90 years undergoing emergency exploratory laparotomy at Mayo Hospital Lahore. The Surgical Apgar Score will be calculated immediately after surgery using three routinely recorded intraoperative factors: estimated blood loss, lowest mean arterial pressure, and lowest heart rate. Patients will be categorized into low Surgical Apgar Score (≤7) and high Surgical Apgar Score (>7) groups. The frequency of direct intensive care unit admission will be compared between the two groups to determine whether a low Surgical Apgar Score is associated with increased need for postoperative intensive care.

Aperçu de l'étude

Statut

Pas encore de recrutement

Les conditions

Description détaillée

Emergency general surgery laparotomy is associated with a substantial risk of postoperative complications and may require postoperative intensive care. In resource-limited healthcare settings, appropriate identification of patients who are likely to require intensive care may assist in postoperative triage and rational allocation of limited critical care resources.

The Surgical Apgar Score (SAS) is a simple 10-point perioperative risk score calculated using three intraoperative parameters: estimated blood loss, lowest mean arterial pressure, and lowest heart rate. Lower scores have been associated with increased postoperative morbidity and mortality in several surgical populations. Previous studies have also reported an association between low SAS and direct postoperative intensive care unit admission. However, evidence regarding its utility among patients undergoing emergency general surgery laparotomy in the local setting is limited.

This study will prospectively observe patients undergoing emergency exploratory laparotomy at Mayo Hospital Lahore and evaluate the relationship between the Surgical Apgar Score and direct postoperative intensive care unit admission. The score will be calculated immediately after surgery using routinely documented intraoperative parameters. Patients will subsequently be categorized according to their SAS, with scores of 7 or less classified as low and scores greater than 7 classified as high.

The study will determine the frequency of direct intensive care unit admission and assess whether patients with a low Surgical Apgar Score are more likely to require direct postoperative intensive care than those with a higher score. Relevant demographic and clinical characteristics will also be recorded to allow assessment of factors that may influence the relationship between SAS and intensive care admission.

The findings may help determine whether the Surgical Apgar Score can serve as a simple and readily available tool for identifying emergency laparotomy patients at increased risk of requiring postoperative intensive care. This may support more objective postoperative triage and resource allocation in high-volume, resource-constrained surgical settings.

Type d'étude

Observationnel

Inscription (Estimé)

77

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Coordonnées de l'étude

  • Nom: Mahnoor Dr Wasim, MBBS, MRCSEd, CHPE
  • Numéro de téléphone: +923075275080
  • E-mail: mahnoorwsm@gmail.com

Sauvegarde des contacts de l'étude

Lieux d'étude

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000
        • Mayo Hospital Lahore
        • Contact:
        • Contact:
        • Chercheur principal:
          • Mahnoor dr Wasim, MBBS, MRCSEd, CHPE

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

  • Enfant
  • Adulte
  • Adulte plus âgé

Accepte les volontaires sains

Non

Méthode d'échantillonnage

Échantillon non probabiliste

Population étudiée

Patients presenting to Mayo Hospital Lahore who undergo emergency exploratory laparotomy for emergency general surgery pathology will be enrolled consecutively. Eligible participants will include males and females aged 13-89 years undergoing emergency laparotomy within 8 hours of surgical evaluation. The study population will include patients undergoing laparotomy for conditions such as gastrointestinal perforation, intestinal obstruction, intra-abdominal sepsis, ischemia, and blunt or penetrating abdominal trauma. The Surgical Apgar Score will be calculated immediately after surgery using estimated blood loss, lowest intraoperative mean arterial pressure, and lowest intraoperative heart rate. Patients will subsequently be classified according to direct postoperative ICU admission.

La description

Inclusion Criteria:

  • Male and female patients aged 13 to 89 years. Patients undergoing emergency exploratory laparotomy at Mayo Hospital Lahore for an emergency general surgery indication.

Patients undergoing laparotomy within 8 hours of surgical evaluation. Patients with emergency general surgery pathologies including gastrointestinal perforation, intestinal obstruction, ischemia, intra-abdominal sepsis, and blunt or penetrating abdominal trauma.

Patients who provide informed consent for participation.

Exclusion Criteria:

  • Patients transferred from another emergency institution when more than 8 hours have elapsed since initial presentation.

Patients who do not undergo emergency exploratory laparotomy. Patients who do not have sufficient intraoperative data to calculate the Surgical Apgar Score.

Patients for whom postoperative disposition to ICU or another postoperative location cannot be determined.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

Cohortes et interventions

Groupe / Cohorte
Low Surgical Apgar Score (≤7)
Participants undergoing emergency exploratory laparotomy who have a Surgical Apgar Score of ≤7, calculated immediately after surgery from estimated blood loss, lowest mean arterial pressure, and lowest heart rate recorded during the operation. This cohort will be observed for direct admission to the intensive care unit following surgery. No intervention is assigned as part of the study.
High Surgical Apgar Score (>7)
Participants undergoing emergency exploratory laparotomy who have a Surgical Apgar Score of >7, calculated immediately after surgery from estimated blood loss, lowest mean arterial pressure, and lowest heart rate recorded during the operation. This cohort will be observed for direct admission to the intensive care unit following surgery. No intervention is assigned as part of the study.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Direct Postoperative Intensive Care Unit Admission
Délai: Within 1 hour after completion of surgery
The proportion of patients transferred directly from the operating room to the Intensive Care Unit immediately following emergency exploratory laparotomy.
Within 1 hour after completion of surgery

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Association of Surgical Apgar Score category with direct postoperative ICU admission
Délai: Perioperative/Periprocedural
The proportion of patients with a low Surgical Apgar Score (≤7) will be compared with patients with a high Surgical Apgar Score (>7) to determine the association between SAS category and direct admission to the intensive care unit following emergency general surgery laparotomy.
Perioperative/Periprocedural

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

King Edward Medical University

Les enquêteurs

  • Chercheur principal: dr zeeshan sarwar, King Edward Medical University

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Publications générales

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Estimé)

24 août 2026

Achèvement primaire (Estimé)

24 novembre 2026

Achèvement de l'étude (Estimé)

24 novembre 2026

Dates d'inscription aux études

Première soumission

28 août 2026

Première soumission répondant aux critères de contrôle qualité

6 septembre 2026

Première publication (Réel)

10 septembre 2026

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

10 septembre 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

6 septembre 2026

Dernière vérification

1 septembre 2026

Plus d'information

Termes liés à cette étude

Mots clés

Autres numéros d'identification d'étude

  • 2023-7628

Plan pour les données individuelles des participants (IPD)

Prévoyez-vous de partager les données individuelles des participants (DPI) ?

NON

Description du régime IPD

Individual participant data will not be shared with other researchers because the study involves patient-level clinical data collected for the purposes of this research, and no data-sharing plan has been established. Data will be securely maintained by the research team in accordance with institutional and ethical requirements.

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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