Surgical Apgar score for predicting complications after hepatectomy for hepatocellular carcinoma

Abstract Background Surgical Apgar score (SAS) was recently proposed as a simple predictor of postoperative complications. A few studies have shown the utility of the SAS in some kinds of surgeries, but it has not been investigated in patients undergoing hepatectomy for hepatocellular carcinoma (HCC). Methods This study included 158 patients undergoing hepatectomy for HCC. The association between SAS and postoperative complications was examined. The patients had postoperative morbidities classified as Clavien–Dindo grade II or higher. Multivariate regression analysis was performed to identify independent factors that significantly influenced the development of postoperative complications. Results Postoperative complications developed in 28 (17.7%) of the 158 patients. The proportion of cases with complications was significantly inversely correlated with SAS (Spearman rank correlation 0.829). The SAS was significantly lower in cases with complications than those without complications (5.6 ± 1.3 points versus 6.6 ± 1.3 points, P  = 0.0004). Comparisons between patients with and without complication showed that preoperative serum albumin level and operation time, as well as SAS, were associated with complications. Multivariate analysis revealed that postoperative complications significantly correlated with the SAS. Conclusions This study demonstrated the clinical utility of SAS in predicting the development of postoperative complications after hepatectomy for HCC.