Role of Surgical Apgar Scores in Predicting the Outcomes of Hollow Viscus Perforation: A Prospective Study in a Tertiary Care Facility in Tripura, India

Background Hollow viscus perforation is a surgical emergency with variable outcomes. The surgical Apgar score (SAS) offers a simple method for risk stratification, but its utility in the patient population is unclear. This study aimed to evaluate the role of SAS in predicting postoperative complications in patients undergoing surgery for hollow viscus perforation. Methods This prospective observational study included 106 patients aged 18 years and above who underwent surgery for hollow viscus perforation at a tertiary care center in Tripura, India, between August 2022 and January 2024. The SAS was calculated intraoperatively based on estimated blood loss, lowest mean arterial pressure, and lowest heart rate. Postoperative complications were graded using the Clavien-Dindo classification. The correlation between SAS and complication severity was analyzed. Results The mean age of the participants was 41.3 ± 15.2 years, with male predominance (87%, 92/106). Gastric perforation was most common (67.9%, 72/106). The most frequently observed SAS was 6, accounting for 39.6% (42/106) of the cases. A strong negative correlation was found between the SAS and Clavien-Dindo grade (Spearman's ρ = -0.664, p < 0.001), indicating that lower SASs were associated with higher grades of complications. Conclusion The SAS demonstrated a significant inverse correlation with postoperative complication severity in patients who had undergone surgery for hollow viscus perforation. The SAS may serve as a simple yet effective tool for predicting outcomes and informing postoperative management in this setting.