AUTHOR=Morand Grégoire B. , Anderegg Nanina , Kleinjung Tobias , Bohlender Jörg E. , Veraguth Dorothe , Broglie Martina A. , Holzmann David , Huber Alexander M. , Röösli Christof , Soyka Michael B. 

TITLE=Assessment of Surgical Complications With Respect to the Surgical Indication: Proposal for a Novel Index

JOURNAL=Frontiers in Surgery

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2021.638057

DOI=10.3389/fsurg.2021.638057

ISSN=2296-875X

ABSTRACT=<p><bold>Introduction:</bold> The Clavien–Dindo classification is a broadly accepted surgical complications classification system, grading complications by the extent of therapy necessary to resolve them. A drawback of the method is that it does not consider why the patient was operated on primarily.</p><p><bold>Methods:</bold> We designed a novel index based on Clavien–Dindo but with respect to the surgical indication. We surveyed an international panel of otolaryngologists who filled out a questionnaire with 32 real case-inspired scenarios. Each case was graded for the surgical complication, surgical indication, and a subjective rating whether the complication was acceptable or not.</p><p><bold>Results:</bold> Seventy-seven otolaryngologists responded to the survey. Mean subjective rating and surgical complication grading for each scenario showed an inverse correlation (<italic>r</italic><sup>2</sup> = 0.147, <italic>p</italic> = 0.044). When grading the surgical complication with respect to the surgical indication, the correlation with the subjective rating increased dramatically (<italic>r</italic><sup>2</sup> = 0.307, <italic>p</italic> = 0.0022).</p><p><bold>Conclusion:</bold> We describe a novel index grading surgical complications with respect to the surgical indication. In our survey, most respondents judged a complication as acceptable or not according to its grade but kept in mind the surgical indication. This subjective judgment could be quantified with our novel index.</p>