Surgical Apgar Score

Assess surgical risk of complications or death at 30 days, as assessed in the post-operative period.


1.Estimated blood loss?
2.Lowest intraoperative mean arterial pressure?
3.Lowest intraoperative heart rate?


The Surgical Apgar Score was developed to allow healthcare providers to assess a patient's condition and risk of major complications or death based on an assessment at the end of any general or vascular surgical procedure.

The surgical score was derived from a retrospective chart analysis and then validated. The primary outcomes measure was incidence of major complication or death within 30 days of operation.

A 10-point score was developed and includes a patient's estimated amount of blood loss, lowest heart rate, and lowest mean arterial pressure during general or vascular operations.

Score is calculated as follows:

Estimated blood loss:

  • >1000 ml - 0 points
  • 601-1000 ml - 1 point
  • 101-600 ml - 2 points
  • ≤ 100 ml - 3 points

Lowest intraoperative mean arterial pressure (mmHg)

  • <40 - 0 points
  • 40-54 - 1 point
  • 55-69 - 2 points
  • ≥70 - 3 points

Lowest intraoperative heart rate (beats/min)

  • >85 - 0 points
  • 76-85 - 1 point
  • 66-75 - 2 points
  • 56-65 - 3 points
  • ≤55 - 4 points

In patients with a score ≤ 4, major complications or death occurred in 59% within 30 days. Among patients with scores of 9 or 10, only 3.6% experienced major complications or died.


Gawande AA, Kwaan MR, Regenbogen SE, Lipsitz SA, Zinner MJ.

An Apgar score for surgery.

Journal of the American College of Surgeons 2007, 204 (2): 201-8

The Surgical Apgar Score calculator is created by QxMD.

Created by on 29/05/2019

By using this site you acknowledge that you have read, understand, and agree to be bound by our terms of use and privacy policy. All content and tools are for educational use only, are not meant to be a substitute for professional advice and should not be used for medical diagnosis and/or medical treatment.

1. Estimated blood loss?

0/3 completed