An observational study in Emergency General Surgery Laparotomy, sponsored by King Edward Medical University. Not yet recruiting at 1 site in Pakistan. Open to participants aged 13 Years to 89 Years. Per ClinicalTrials.gov, last updated 2026-09-10.
Sponsored by King Edward Medical University · Observational
This prospective observational study will evaluate whether the Surgical Apgar Score can help identify patients who require direct admission to the intensive care unit after emergency abdominal surgery. The study will include patients aged over 12 and under 90 years undergoing emergency exploratory laparotomy at Mayo Hospital Lahore. The Surgical Apgar Score will be calculated immediately after surgery using three routinely recorded intraoperative factors: estimated blood loss, lowest mean arterial pressure, and lowest heart rate. Patients will be categorized into low Surgical Apgar Score (≤7) and high Surgical Apgar Score (>7) groups. The frequency of direct intensive care unit admission will be compared between the two groups to determine whether a low Surgical Apgar Score is associated with increased need for postoperative intensive care.
Emergency general surgery laparotomy is associated with a substantial risk of postoperative complications and may require postoperative intensive care. In resource-limited healthcare settings, appropriate identification of patients who are likely to require intensive care may assist in postoperative triage and rational allocation of limited critical care resources.
The Surgical Apgar Score (SAS) is a simple 10-point perioperative risk score calculated using three intraoperative parameters: estimated blood loss, lowest mean arterial pressure, and lowest heart rate. Lower scores have been associated with increased postoperative morbidity and mortality in several surgical populations. Previous studies have also reported an association between low SAS and direct postoperative intensive care unit admission. However, evidence regarding its utility among patients undergoing emergency general surgery laparotomy in the local setting is limited.
This study will prospectively observe patients undergoing emergency exploratory laparotomy at Mayo Hospital Lahore and evaluate the relationship between the Surgical Apgar Score and direct postoperative intensive care unit admission. The score will be calculated immediately after surgery using routinely documented intraoperative parameters. Patients will subsequently be categorized according to their SAS, with scores of 7 or less classified as low and scores greater than 7 classified as high.
The study will determine the frequency of direct intensive care unit admission and assess whether patients with a low Surgical Apgar Score are more likely to require direct postoperative intensive care than those with a higher score. Relevant demographic and clinical characteristics will also be recorded to allow assessment of factors that may influence the relationship between SAS and intensive care admission.
The findings may help determine whether the Surgical Apgar Score can serve as a simple and readily available tool for identifying emergency laparotomy patients at increased risk of requiring postoperative intensive care. This may support more objective postoperative triage and resource allocation in high-volume, resource-constrained surgical settings.
King Edward Medical University is the lead sponsor of 82 studies on the registry; 27 are open to participants now.
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Patients presenting to Mayo Hospital Lahore who undergo emergency exploratory laparotomy for emergency general surgery pathology will be enrolled consecutively. Eligible participants will include males and females aged 13-89 years undergoing emergency laparotomy within 8 hours of surgical evaluation. The study population will include patients undergoing laparotomy for conditions such as gastrointestinal perforation, intestinal obstruction, intra-abdominal sepsis, ischemia, and blunt or penetrating abdominal trauma. The Surgical Apgar Score will be calculated immediately after surgery using estimated blood loss, lowest intraoperative mean arterial pressure, and lowest intraoperative heart rate. Patients will subsequently be classified according to direct postoperative ICU admission.
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Patients undergoing laparotomy within 8 hours of surgical evaluation. Patients with emergency general surgery pathologies including gastrointestinal perforation, intestinal obstruction, ischemia, intra-abdominal sepsis, and blunt or penetrating abdominal trauma.
Patients who provide for participation.
Exclusion Criteria:
Patients who do not undergo emergency exploratory laparotomy. Patients who do not have sufficient intraoperative data to calculate the Surgical Apgar Score.
Patients for whom postoperative disposition to ICU or another postoperative location cannot be determined.
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Participants undergoing emergency exploratory laparotomy who have a Surgical Apgar Score of ≤7, calculated immediately after surgery from estimated blood loss, lowest mean arterial pressure, and lowest heart rate recorded during the operation. This cohort will be observed for direct admission to the intensive care unit following surgery. No intervention is assigned as part of the study.
Participants undergoing emergency exploratory laparotomy who have a Surgical Apgar Score of \>7, calculated immediately after surgery from estimated blood loss, lowest mean arterial pressure, and lowest heart rate recorded during the operation. This cohort will be observed for direct admission to the intensive care unit following surgery. No intervention is assigned as part of the study.
Direct Postoperative Intensive Care Unit Admission
The proportion of patients transferred directly from the operating room to the Intensive Care Unit immediately following emergency exploratory laparotomy.
Time frame: Within 1 hour after completion of surgery
Association of Surgical Apgar Score category with direct postoperative ICU admission
The proportion of patients with a low Surgical Apgar Score (≤7) will be compared with patients with a high Surgical Apgar Score (\>7) to determine the association between SAS category and direct admission to the intensive care unit following emergency general surgery laparotomy.
Time frame: Perioperative/Periprocedural
Plan to share: No — Individual participant data will not be shared with other researchers because the study involves patient-level clinical data collected for the purposes of this research, and no data-sharing plan has been established. Data will be securely maintained by the research team in accordance with institutional and ethical requirements.
This study is not yet recruiting, as verified in Sep 2026. You cannot join it, but the record below documents what was studied.
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King Edward Medical University