Background and Purpose of the Trial

Post-operative complications significantly affect surgical outcomes, recovery, and overall patient safety. Accurate preoperative and intraoperative risk assessment is crucial for optimizing perioperative management and resource allocation.

The American Society of Anesthesiologists Physical Status (ASA-PS) classification is widely used to assess a patient’s preoperative health and comorbidities, but it does not fully account for intraoperative physiological changes. In contrast, the Modified Surgical Apgar Score (mSAS) evaluates real-time intraoperative parameters—such as estimated blood loss, mean arterial pressure, and heart rate—allowing dynamic risk prediction immediately after surgery.

However, limited evidence exists comparing the predictive accuracy of these two scoring systems in patients undergoing laparotomy, a major abdominal procedure associated with significant morbidity.

This study aims to compare the Modified Surgical Apgar Score (mSAS) and ASA-PS classification in predicting post-operative complications in laparotomy patients. By identifying which system more accurately predicts adverse outcomes, the study seeks to enhance perioperative risk stratification, guide early interventions, and ultimately improve patient outcomes.