Surgical Apgar Score (intraoperative outcome)

Surgical Apgar Score (0–10) from estimated blood loss and the lowest intraoperative mean arterial pressure and heart rate; ≤ 4 flags high major-complication/death risk.

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

Estimated blood loss
200 mL
Lowest MAP
60 mmHg
Lowest heart rate
80 bpm

Result: Surgical Apgar Score 5 of 10 — intermediate risk.

The tool opens with these values already filled in. Replace them with your own.

What the result means

Risk
Score ≤ 4 carries a high major-complication/death risk; the gradient runs ≈4% at 9–10 to ≈14–58% at ≤ 4. Distinct from the neonatal Apgar.

What you enter

  • Estimated blood loss
  • Lowest MAP
  • Lowest heart rate
How this is calculated
Points
Estimated blood loss (≤100 mL=3, 101–600=2, 601–1000=1, >1000=0) + lowest MAP (≥70=3, 55–69=2, 40–54=1, <40=0) + lowest HR (≤55=4, 56–65=3, 66–75=2, 76–85=1, >85=0).

Gawande AA, Kwaan MR, Regenbogen SE, Lipsitz SA, Zinner MJ. An Apgar score for surgery. J Am Coll Surg. 2007;204(2):201-208. Validation: Regenbogen SE, et al. Arch Surg. 2009;144(1):30-36. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.