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

6. september 2026 oppdatert av: 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.

Studieoversikt

Status

Har ikke rekruttert ennå

Forhold

Detaljert beskrivelse

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

Observasjonsmessig

Registrering (Antatt)

77

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

  • Navn: Mahnoor Dr Wasim, MBBS, MRCSEd, CHPE
  • Telefonnummer: +923075275080
  • E-post: mahnoorwsm@gmail.com

Studer Kontakt Backup

Studiesteder

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000
        • Mayo Hospital Lahore
        • Ta kontakt med:
        • Ta kontakt med:
        • Hovedetterforsker:
          • Mahnoor dr Wasim, MBBS, MRCSEd, CHPE

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Barn
  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Prøvetakingsmetode

Ikke-sannsynlighetsprøve

Studiepopulasjon

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.

Beskrivelse

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.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

Kohorter og intervensjoner

Gruppe / Kohort
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.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Direct Postoperative Intensive Care Unit Admission
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Association of Surgical Apgar Score category with direct postoperative ICU admission
Tidsramme: 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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

King Edward Medical University

Etterforskere

  • Hovedetterforsker: dr zeeshan sarwar, King Edward Medical University

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

24. august 2026

Primær fullføring (Antatt)

24. november 2026

Studiet fullført (Antatt)

24. november 2026

Datoer for studieregistrering

Først innsendt

28. august 2026

Først innsendt som oppfylte QC-kriteriene

6. september 2026

Først lagt ut (Faktiske)

10. september 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

10. september 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

6. september 2026

Sist bekreftet

1. september 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Andre studie-ID-numre

  • 2023-7628

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

IPD-planbeskrivelse

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.

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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