Predictive Value of the Surgical Apgar Score for Major Postoperative Complications: A Prospective Observational Study in a Tertiary Care Setting

In this prospective heterogeneous surgical cohort, the SAS demonstrated limited to modest discriminative ability for clinically relevant postoperative complications. The findings suggest limited utility of the SAS as a standalone risk stratification tool in heterogeneous surgical populations. At most, the score may provide complementary intraoperative risk information when interpreted alongside established preoperative risk measures and clinical judgment. Further validation in larger, procedure-specific cohorts with standardized outcome definitions and internal validation is required.