BACKGROUND: We recently reported a grading system for surgical complications. This system proved to have a high sensitivity for recording minor but meaningful complications prolonging hospital stay in patients after colorectal surgery. We aimed to prospectively validate the complication grading system in a general surgery department over 1 year. METHODS: All surgical procedures and related complications were prospectively recorded between January 1st and December 31st, 2009. Surgical complications were graded on a severity scale of 1-5. The system classifies short-term outcome by grade emphasizing intensity of therapy required for treatment of the defined complication. RESULTS: During the study period, 2114 patients underwent surgery. Elective and oncological surgeries were performed in 1606 (76%) and 465 (22%) patients, respectively. There were 422 surgical complications in 304 (14%) patients (Grade 1/2: 203 [67%]; Grade 3/4: 90 [29%]; Grade 5: 11 [4%]). Median length of stay correlated significantly with complication severity: 2.3 d for no complication, 6.2 and 11.8 d for Grades 1/2 and 3/4, respectively (P < 0.001). Older age (OR 2.75, P < 0.001), comorbidities (OR 1.44, P = 0.02), American Society of Anesthesiology score >2 (OR 2.07, P < 0.001), contamination Grade (OR 1.85, P = 0.001), oncological (OR 2.82, P < 0.001), open (OR 1.22, P = 0.03), prolonged >120 min (OR 2.08, P < 0.001), and emergency surgery (OR 1.42, P = 0.02) independently predicted postoperative complications. CONCLUSIONS: This system of grading surgical complications permits standardized reporting of surgical morbidity according to the severity of impact. Prospective validation of this system supports its use in a general surgery setting as a tool for surgical outcome assessment and quality assurance.
BACKGROUND: We recently reported a grading system for surgical complications. This system proved to have a high sensitivity for recording minor but meaningful complications prolonging hospital stay in patients after colorectal surgery. We aimed to prospectively validate the complication grading system in a general surgery department over 1 year. METHODS: All surgical procedures and related complications were prospectively recorded between January 1st and December 31st, 2009. Surgical complications were graded on a severity scale of 1-5. The system classifies short-term outcome by grade emphasizing intensity of therapy required for treatment of the defined complication. RESULTS: During the study period, 2114 patients underwent surgery. Elective and oncological surgeries were performed in 1606 (76%) and 465 (22%) patients, respectively. There were 422 surgical complications in 304 (14%) patients (Grade 1/2: 203 [67%]; Grade 3/4: 90 [29%]; Grade 5: 11 [4%]). Median length of stay correlated significantly with complication severity: 2.3 d for no complication, 6.2 and 11.8 d for Grades 1/2 and 3/4, respectively (P < 0.001). Older age (OR 2.75, P < 0.001), comorbidities (OR 1.44, P = 0.02), American Society of Anesthesiology score >2 (OR 2.07, P < 0.001), contamination Grade (OR 1.85, P = 0.001), oncological (OR 2.82, P < 0.001), open (OR 1.22, P = 0.03), prolonged >120 min (OR 2.08, P < 0.001), and emergency surgery (OR 1.42, P = 0.02) independently predicted postoperative complications. CONCLUSIONS: This system of grading surgical complications permits standardized reporting of surgical morbidity according to the severity of impact. Prospective validation of this system supports its use in a general surgery setting as a tool for surgical outcome assessment and quality assurance.
Authors: Nina Nederlof; Annelijn E Slaman; Pieter van Hagen; Ate van der Gaast; Ksenija Slankamenac; Suzanne S Gisbertz; Jan J B van Lanschot; Bas P L Wijnhoven; Mark I van Berge Henegouwen Journal: Ann Surg Oncol Date: 2016-06-14 Impact factor: 5.344
Authors: Salome Dell-Kuster; Nuno V Gomes; Larsa Gawria; Soheila Aghlmandi; Maame Aduse-Poku; Ian Bissett; Catherine Blanc; Christian Brandt; Richard B Ten Broek; Heinz R Bruppacher; Cillian Clancy; Paolo Delrio; Eloy Espin; Konstantinos Galanos-Demiris; I Ethem Gecim; Shahbaz Ghaffari; Olivier Gié; Barbara Goebel; Dieter Hahnloser; Friedrich Herbst; Ioannidis Orestis; Sonja Joller; Soojin Kang; Rocio Martín; Johannes Mayr; Sonja Meier; Jothi Murugesan; Deirdre Nally; Menekse Ozcelik; Ugo Pace; Michael Passeri; Simone Rabanser; Barbara Ranter; Daniela Rega; Paul F Ridgway; Camiel Rosman; Roger Schmid; Philippe Schumacher; Alejandro Solis-Pena; Laura Villarino; Dionisios Vrochides; Alexander Engel; Greg O'Grady; Benjamin Loveday; Luzius A Steiner; Harry Van Goor; Heiner C Bucher; Pierre-Alain Clavien; Philipp Kirchhoff; Rachel Rosenthal Journal: BMJ Date: 2020-08-25
Authors: Omid Madadi-Sanjani; Christoph Zoeller; Joachim F Kuebler; Alejandro D Hofmann; Jens Dingemann; Soeren Wiesner; Julia Brendel; Benno M Ure Journal: BJS Open Date: 2021-11-09