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=Volume 8 - 2021

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=Introduction:
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 is does not consider why the patient was operated primarily.

Methods: 
We designed a novel index based on Clavien-Dindo but respecting 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.

Results: Seventy-seven otolaryngologists responded to the survey. Mean subjective rating and surgical complication grading for each scenario showed an inverse correlation (r2=0.147, p=0.044). When grading the surgical complication in respect of the surgical indication, the correlation with the subjective rating increased dramatically r2=0.307, p=0.0022)).

Conclusion:
We describe a novel index grading surgical complications respecting 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 judgement could be quantified with our novel index.