Surgical Apgar Score — Postoperative Complication Risk

The Surgical Apgar Score (SAS) is a validated 3-item intraoperative scoring system for predicting major postoperative complications (death, need for reoperation, or life-threatening complications requiring ICU admission) within 30 days of surgery. Developed by Gawande et al. (2007), it uses estimated blood loss, lowest mean arterial pressure, and lowest heart rate recorded during the operation — information available at the end of any surgical procedure. Score range: 0–10; higher scores predict better postoperative outcomes.