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

6 september 2026 bijgewerkt door: 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.

Studie Overzicht

Toestand

Nog niet aan het werven

Conditie

Gedetailleerde beschrijving

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.

Studietype

Observationeel

Inschrijving (Geschat)

77

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

  • Naam: Mahnoor Dr Wasim, MBBS, MRCSEd, CHPE
  • Telefoonnummer: +923075275080
  • E-mail: mahnoorwsm@gmail.com

Studie Contact Back-up

Studie Locaties

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

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Kind
  • Volwassen
  • Oudere volwassene

Accepteert gezonde vrijwilligers

Nee

Bemonsteringsmethode

Niet-waarschijnlijkheidssteekproef

Studie Bevolking

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.

Beschrijving

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.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

Cohorten en interventies

Groep / Cohort
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.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Direct Postoperative Intensive Care Unit Admission
Tijdsspanne: 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

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Association of Surgical Apgar Score category with direct postoperative ICU admission
Tijdsspanne: 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

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

King Edward Medical University

Onderzoekers

  • Hoofdonderzoeker: dr zeeshan sarwar, King Edward Medical University

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Algemene publicaties

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Geschat)

24 augustus 2026

Primaire voltooiing (Geschat)

24 november 2026

Studie voltooiing (Geschat)

24 november 2026

Studieregistratiedata

Eerst ingediend

28 augustus 2026

Eerst ingediend dat voldeed aan de QC-criteria

6 september 2026

Eerst geplaatst (Werkelijk)

10 september 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

10 september 2026

Laatste update ingediend die voldeed aan QC-criteria

6 september 2026

Laatst geverifieerd

1 september 2026

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Andere studie-ID-nummers

  • 2023-7628

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Beschrijving IPD-plan

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.

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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