RT Journal
A1 Campbell DA, Jr
T1 UTility of the surgical apgar score—invited critique
JF Archives of Surgery
JO Archives of Surgery
YR 2009
FD January 19
VO 144
IS 1
SP 37
OP 37
DO 10.1001/archsurg.2008.505
UL http://dx.doi.org/10.1001/archsurg.2008.505
AB 
I disagree with the authors' assertion that the Surgical Apgar Score “does not allow for comparison of quality among institutions.” However, the score requires a little tweaking for this application. If one stratifies patient populations by preoperative risk Current Procedural Terminology code, or both, one might find some real differences in Surgical Apgar Score from institution to institution within these categories. These differences could relate to surgical skill, anesthetic management, or system problems, given that all other patient and procedural factors are equal. Identifying these variations might then uncover a path of quality improvement that was not evident previously.