Surgical Apgar Score (SAS) for Postoperative Risk

Consider admission to a closely monitored setting (ICU, stepdown unit) for patients with low Surgical Apgar Scores as they are high risk for requiring ICU-level care within the next 72 hours.

• For patients with scores ≥7, consider usual care.
• Patients with scores ≤6, consider close observation with a low-threshold for testing if or when a patient begins to show signs of surgical complication, given they are at high risk for complication, along with usual standard of care. It may also be useful to make nursing aware of these patients who are particularly high risk so the care team can be notified early of any signs of decompensation.

Patients with a score of 6 or less are high risk for major complication, and patients with a score of 4 or less are very high risk and should be considered at high risk of decompensation and monitored very closely, often in an ICU setting.