Prospective observational cohort study on grading the severity of postoperative complications in global surgery research
作者： Norbert Fischbach , Reinhold Klug , Elisabeth Schneider , Martin Vesely , Reinhart Wickenhauser
DOI: 10.1002/BJS.11025
关键词:
摘要: BACKGROUND: The Clavien-Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by treatment provided. However, it unclear whether can be internationally studies across differing healthcare systems high- (HICs) and low- middle-income countries (LMICs). METHODS: was a secondary analysis of International Surgical Outcomes Study (ISOS), prospective observational cohort study elective surgery adults. Data collection occurred over 7-day period. Severity graded using simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). compared intraclass correlation coefficient (ICC). are presented as frequencies ICC values (with 95 per cent c.i.). stratified income status country, comparing HICs with LMICs. RESULTS: A total 44 814 patients were recruited from 474 hospitals 27 (19 8 LMICs). Some 7508 (16·8 cent) experienced at least one complication, equivalent to 11 664 total. Using classification, 5504 (47·2 mild, 4244 (36·4 1916 (16·4 severe. Clavien-Dindo, 6781 (58·1 I II, 1740 (14·9 III, 2408 (20·6 IV 735 (6·3 V. Agreement between poor overall (ICC 0·41, c.i. 0·20 0·55), LMICs 0·23, 0·05 0·38) 0·46, 0·25 0·59). CONCLUSION: Caution recommended when grade global studies, this may introduce bias unintentionally.
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