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The following is a summary of “Milestones in Surgical Complication Reporting Clavien-Dindo Classification 20 Years and Comprehensive Complication Index 10 Years,” published in the November 2024 issue of Surgery by Abbassi et al.
Standardized outcome reporting is essential for evaluating surgical procedures. The Clavien-Dindo classification (CDC) and Comprehensive Complication Index (CCI®) are recommended for assessing postoperative complications, but some complex scenarios still lack clear guidance for grading.
Researchers conducted a retrospective study to improve the application of the CDC and CCI®) in challenging clinical scenarios.
They assessed the use of the CDC and CCI® in 1327 RCTs and surveyed 163 international surgeons about grading complications in 20 complex clinical cases. A core group of 5 experts developed recommendations based on the responses.
The results showed 1,327 RCTs selected (July 2023) by the CDC and/or CCI® to assess morbidity, with over 200 new RCTs published per year. Only a third (335) of the RCTs provided the complete range of CDC grades, including all subgrades, 89 of 163 surgeons (response rate: 55%) completed the survey, leading to recommendations on how to count repetitive interventions, complications followed by further complications, complications occurring before referral, and expected or unrelated complications. Invasive blank diagnostic interventions should not be counted as complications.
They concluded that the increasing use of the CDC and CCI® in RCTs highlighted the importance of consistent application to improve complication reporting and healthcare quality.
