Classification of intraoperative adverse events in visceral surgery.
Details
Serval ID
serval:BIB_7BD06F4D9B06
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Classification of intraoperative adverse events in visceral surgery.
Journal
Surgery
Working group(s)
ClassIntra Study Group
Contributor(s)
Ten Broek R.B., Rosman C., Aduse-Poku M., Aghlamandi S., Bissett I., Blanc C., Brandt C., Bruppacher H.R., Bucher H.C., Clancy C., Clavien P.A., Delrio P., Espin E., Engel A., Gomes N.V., Galanos-Demiris K., Gecim E., Ghaffari S., Gié O., Goebel B., Hahnloser D., Herbst F., Ionnadis O., Joller S., Kang S., Kirchhoff P., Loveday B., Martín R., Mayr J., Meier S., Murugesan J., Nally D., O'Grady G., Ozcelik M., Pace U., Passeri M., Rabanser S., Ranter B., Rega D., Ridgway P.F., Schmid R., Schumacher P., Solis A., Steiner L.A., Villarino L., Vrochides D.
ISSN
1532-7361 (Electronic)
ISSN-L
0039-6060
Publication state
Published
Issued date
06/2022
Peer-reviewed
Oui
Volume
171
Number
6
Pages
1570-1579
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Intraoperative adverse events (iAEs) are frequent in visceral surgery, but severity and related postoperative outcome are poorly investigated. A novel classification of intraoperative adverse events, ClassIntra, includes surgical and anesthesiologic intraoperative adverse events using 5 severity grades and showed a high criterion and construct validity across all surgical disciplines. ClassIntra was studied for reproducibility in a prespecified group of patients undergoing visceral surgery.
iAEs were recorded in all patients enrolled in the ClassIntra validation study (NCT03009929). Postoperative complications were assessed daily according to the Clavien-Dindo classification. Results of the visceral group were compared with those of the non-visceral group and the full cohort. The risk-adjusted association between most severe intra and postoperative complications was investigated in a multivariable proportional odds model. Second, risk-adjusted association between ClassIntra grade and Comprehensive Complication Index, and postoperative length of stay was investigated.
In total, 1,270 out of 2,520 patients (50%) underwent visceral surgery. Compared with the nonvisceral group and full cohort, more intraoperative (337/1270 [27%] vs 273/1250 [22%] vs 610/2520 [24%] patients) and postoperative complications (457/1270 [36%] vs 381/1250 [30%] vs 838/2520 [33%] patients) occurred. The risk for a more severe postoperative complication increased with each ClassIntra grade (odds ratio [95% confidence interval] I vs 0 1.10 [0.73 to 1.66], II vs 0 1.69 [1.10 to 2.60], III vs 0 2.31 [1.21 to 4.41], IV vs 0 2.35 [0.69 to 8.06]). Accordingly, CCI and postoperative length of stay increased with each ClassIntra grade in the visceral group, comparable with the nonvisceral and full cohort.
Consistent results for the association of intraoperative adverse events and patient outcomes render ClassIntra a valuable instrument in visceral surgery.
iAEs were recorded in all patients enrolled in the ClassIntra validation study (NCT03009929). Postoperative complications were assessed daily according to the Clavien-Dindo classification. Results of the visceral group were compared with those of the non-visceral group and the full cohort. The risk-adjusted association between most severe intra and postoperative complications was investigated in a multivariable proportional odds model. Second, risk-adjusted association between ClassIntra grade and Comprehensive Complication Index, and postoperative length of stay was investigated.
In total, 1,270 out of 2,520 patients (50%) underwent visceral surgery. Compared with the nonvisceral group and full cohort, more intraoperative (337/1270 [27%] vs 273/1250 [22%] vs 610/2520 [24%] patients) and postoperative complications (457/1270 [36%] vs 381/1250 [30%] vs 838/2520 [33%] patients) occurred. The risk for a more severe postoperative complication increased with each ClassIntra grade (odds ratio [95% confidence interval] I vs 0 1.10 [0.73 to 1.66], II vs 0 1.69 [1.10 to 2.60], III vs 0 2.31 [1.21 to 4.41], IV vs 0 2.35 [0.69 to 8.06]). Accordingly, CCI and postoperative length of stay increased with each ClassIntra grade in the visceral group, comparable with the nonvisceral and full cohort.
Consistent results for the association of intraoperative adverse events and patient outcomes render ClassIntra a valuable instrument in visceral surgery.
Keywords
Clinical Studies as Topic, Digestive System Surgical Procedures/adverse effects, Humans, Intraoperative Complications/epidemiology, Intraoperative Complications/etiology, Postoperative Complications/epidemiology, Postoperative Complications/etiology, Postoperative Period, Reproducibility of Results, Retrospective Studies
Pubmed
Web of science
Create date
26/09/2023 13:50
Last modification date
27/09/2023 5:59
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