Application of the Surgical APGAR Score to Predict Intensive Care Unit Admission and Post-Operative Outcomes…

Case-controlMedicina (Kaunas, Lithuania)· Nov 2025

Application of the Surgical APGAR Score to Predict Intensive Care Unit Admission and Post-Operative Outcomes in Cesarean Hysterectomy for Placenta Accreta Spectrum.

Emily Root, Jacqueline Curbelo, Patrick Ramsey, Jessian L Munoz

Obstetric AnesthesiaCase-controlPrognosisQ4IF 0.1

Surgical Apgar Score poorly predicts intensive care unit admission after cesarean hysterectomy for placenta accreta spectrum

Application of the Surgical APGAR Score to Predict Intensive Care Unit Admission and Post-Operative Outcomes in Cesarean Hysterectomy for Placenta Accreta Spectrum.

Emily Root … Jessian L Munoz

Medicina (Kaunas, Lithuania) · Nov 2025 · Q4 in General Medicine

Background

Placenta Accreta Spectrum (Placenta Accreta Spectrum) encompasses a continuum of abnormal placentation conditions associated with significant maternal and fetal morbidity.

Purpose

The purpose of this study was to apply the Surgical APGAR Score (SAS, version 9) to patients undergoing management of Placenta Accreta Spectrum to determine if it can predict intensive care unit admission in this population.

Methods

We retrospectively analyzed 127 cases of pathology-confirmed Placenta Accreta Spectrum patients who underwent cesarean hysterectomy in singleton, non-anomalous, viable pregnancies.

n = 127 cases

Results

AUROC of 0.6; 1.0 is perfect, so this barely beats a coin flip

OR 2.28 (95% CI 2.28 to 2.28)

null 1

2.28

CI excludes the null - significant

More results

Fifty-eight patients (45%) were admitted post-operatively to the intensive care unit, while 69 patients (55%) were admitted for routine care to the post-anesthesia care unit.

Baseline demographics were similar between groups.

Forty-four patients (52%) admitted to the intensive care unit had a SAS score < 4.

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Conclusion · 1 of 2

The SAS system is a poor tool for the prediction of intensive care unit admission in patients with Placenta Accreta Spectrum undergoing cesarean hysterectomy.

Conclusion · 2 of 2

A risk calculator that accounts for the unique physiologic changes in pregnancy and high risk for pregnancy is needed.

Application of the Surgical APGAR Score to Predict Intensive Care Unit Admission and Post-Operative Outcomes in Cesarean Hysterectomy for Placenta Accreta Spectrum.

Application of the Surgical APGAR Score to Predict Intensive Care Unit Admission and Post-Operative Outcomes in Cesarean Hysterectomy for Placenta Accreta Spectrum.

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