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Application of Surgical Apgar Score in intracranial meningioma surgery

Surgical resection is the main therapeutic option for intracranial meningiomas, but it is not without significant morbidities. The Surgical Apgar Score (SAS), assessed by intraoperative blood pressure, heart rate, and blood loss, was developed for prognostic prediction in general and vascular surger...

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Autores principales: Hsu, Shih-Yuan, Ou, Chien-Yu, Ho, Yu-Ni, Huang, Yu-Hua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5383036/
https://www.ncbi.nlm.nih.gov/pubmed/28384177
http://dx.doi.org/10.1371/journal.pone.0174328
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author Hsu, Shih-Yuan
Ou, Chien-Yu
Ho, Yu-Ni
Huang, Yu-Hua
author_facet Hsu, Shih-Yuan
Ou, Chien-Yu
Ho, Yu-Ni
Huang, Yu-Hua
author_sort Hsu, Shih-Yuan
collection PubMed
description Surgical resection is the main therapeutic option for intracranial meningiomas, but it is not without significant morbidities. The Surgical Apgar Score (SAS), assessed by intraoperative blood pressure, heart rate, and blood loss, was developed for prognostic prediction in general and vascular surgery. We aimed to examine whether the application of SAS in patients undergoing craniotomy for meningioma resection can predict postoperative major complications. We retrospectively enrolled 99 patients that had undergone intracranial meningioma surgery. The patients were subdivided into 2 groups based on whether major complications were present (N = 34) or not (N = 65). We recognized the intergroup differences in SAS and clinical variables. The incidence of 30-day major complications in patients after operation was 34.3%. The lengths of ICU and hospital stay for the morbid cases were prolonged significantly (p = 0.009, p < 0.001, respectively). In the multivariate logistic regression model, SAS was an independent predicting factor of major complications following surgery for intracranial meningiomas (odds ratio, 95% confidence interval = 0.57, 0.38–0.87; p = 0.009), and thus a decrease of one mean SAS increased the rate of major complications by 43%. In conclusions, SAS is an independent predictor of major complications in patients undergoing intracranial meningioma surgery, and provides acceptable risk discrimination. Since this scoring system is relatively simple, objective, and practical, we suggest that SAS be included as an indicator in the guidance for the level of care after craniotomy for meningioma resection.
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spelling pubmed-53830362017-05-03 Application of Surgical Apgar Score in intracranial meningioma surgery Hsu, Shih-Yuan Ou, Chien-Yu Ho, Yu-Ni Huang, Yu-Hua PLoS One Research Article Surgical resection is the main therapeutic option for intracranial meningiomas, but it is not without significant morbidities. The Surgical Apgar Score (SAS), assessed by intraoperative blood pressure, heart rate, and blood loss, was developed for prognostic prediction in general and vascular surgery. We aimed to examine whether the application of SAS in patients undergoing craniotomy for meningioma resection can predict postoperative major complications. We retrospectively enrolled 99 patients that had undergone intracranial meningioma surgery. The patients were subdivided into 2 groups based on whether major complications were present (N = 34) or not (N = 65). We recognized the intergroup differences in SAS and clinical variables. The incidence of 30-day major complications in patients after operation was 34.3%. The lengths of ICU and hospital stay for the morbid cases were prolonged significantly (p = 0.009, p < 0.001, respectively). In the multivariate logistic regression model, SAS was an independent predicting factor of major complications following surgery for intracranial meningiomas (odds ratio, 95% confidence interval = 0.57, 0.38–0.87; p = 0.009), and thus a decrease of one mean SAS increased the rate of major complications by 43%. In conclusions, SAS is an independent predictor of major complications in patients undergoing intracranial meningioma surgery, and provides acceptable risk discrimination. Since this scoring system is relatively simple, objective, and practical, we suggest that SAS be included as an indicator in the guidance for the level of care after craniotomy for meningioma resection. Public Library of Science 2017-04-06 /pmc/articles/PMC5383036/ /pubmed/28384177 http://dx.doi.org/10.1371/journal.pone.0174328 Text en © 2017 Hsu et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Hsu, Shih-Yuan
Ou, Chien-Yu
Ho, Yu-Ni
Huang, Yu-Hua
Application of Surgical Apgar Score in intracranial meningioma surgery
title Application of Surgical Apgar Score in intracranial meningioma surgery
title_full Application of Surgical Apgar Score in intracranial meningioma surgery
title_fullStr Application of Surgical Apgar Score in intracranial meningioma surgery
title_full_unstemmed Application of Surgical Apgar Score in intracranial meningioma surgery
title_short Application of Surgical Apgar Score in intracranial meningioma surgery
title_sort application of surgical apgar score in intracranial meningioma surgery
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5383036/
https://www.ncbi.nlm.nih.gov/pubmed/28384177
http://dx.doi.org/10.1371/journal.pone.0174328
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