Validation of a modified Clavien-Dindo Classification for postoperative complications in orthopedic surgery
Introduction: Postoperative complications (PCs) constitute any deviation from the normal postoperative course. Reporting of PCs remains a challenge, multiple classification systems have been proposed, however these have not been validated across surgical specialties. Clavien and Dindo (DCCS) develop...
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| Formato: | Artículo revista |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2020
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/27931 |
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I10-R327-article-27931 |
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Universidad Nacional de Córdoba |
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I-10 |
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R-327 |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Inglés |
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Artículo revista |
| topic |
postoperative complications orthopedics health systems complicaciones posoperatorias ortopedia sistemas de salud complicações pós-operatórias ortopedia sistemas de saúde |
| spellingShingle |
postoperative complications orthopedics health systems complicaciones posoperatorias ortopedia sistemas de salud complicações pós-operatórias ortopedia sistemas de saúde Camino Willhuber, Gaston Slullitel, Pablo Taype Zamboni, Danilo Albergo, Jose Terrasa, Sergio Piuzzi, Nicolas Boretto, Jorge Validation of a modified Clavien-Dindo Classification for postoperative complications in orthopedic surgery |
| topic_facet |
postoperative complications orthopedics health systems complicaciones posoperatorias ortopedia sistemas de salud complicações pós-operatórias ortopedia sistemas de saúde |
| author |
Camino Willhuber, Gaston Slullitel, Pablo Taype Zamboni, Danilo Albergo, Jose Terrasa, Sergio Piuzzi, Nicolas Boretto, Jorge |
| author_facet |
Camino Willhuber, Gaston Slullitel, Pablo Taype Zamboni, Danilo Albergo, Jose Terrasa, Sergio Piuzzi, Nicolas Boretto, Jorge |
| author_sort |
Camino Willhuber, Gaston |
| title |
Validation of a modified Clavien-Dindo Classification for postoperative complications in orthopedic surgery |
| title_short |
Validation of a modified Clavien-Dindo Classification for postoperative complications in orthopedic surgery |
| title_full |
Validation of a modified Clavien-Dindo Classification for postoperative complications in orthopedic surgery |
| title_fullStr |
Validation of a modified Clavien-Dindo Classification for postoperative complications in orthopedic surgery |
| title_full_unstemmed |
Validation of a modified Clavien-Dindo Classification for postoperative complications in orthopedic surgery |
| title_sort |
validation of a modified clavien-dindo classification for postoperative complications in orthopedic surgery |
| description |
Introduction: Postoperative complications (PCs) constitute any deviation from the normal postoperative course.
Reporting of PCs remains a challenge, multiple classification systems have been proposed, however these have not been validated across surgical specialties. Clavien and Dindo (DCCS) developed a system for General Surgery and has been adopted in different fields. Nonetheless, this classification has not been adapted to Orthopedics. The objective of this study was to adapt the Clavien-Dindo classification to orthopedic scenarios and to determine the intra and interobserver reliability.
Methods: The designer team adapted the Clavien Dindo classification to orthopedic scenarios. Ten orthopedic observers with different degrees of training and experience were selected to evaluate the classification. 48 simulated clinical scenarios of complications and another negative outcomes such as failure to cure and sequelae were sent by electronic format independently. A second round of scoring was performed 30 days later to assess the intraobserver concordance.
Results: We found a high interobserver and intraobserver reliability for both the first and second evaluation (Kappa 0.88 and 0.91, respectively). In addition, the intraobserver analysis showed a very good correlation (Kappa 0.93).
Discussion: The DCCS classification has been developed for general surgery and has been widely applied in the different surgical subspecialties. In Orthopedics, this classification was validated to hip and pediatric surgery. Therefore, our study involved an adaptation of the classification to general and specific orthopedic scenarios of the different orthopedic subspecialties. This classification may be a useful tool for documenting complications in orthopedic surgery.
Keywords: postoperative complications; orthopedics; health systems
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| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2020 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/27931 |
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I10-R327-article-279312024-08-27T18:27:51Z Validation of a modified Clavien-Dindo Classification for postoperative complications in orthopedic surgery Validación de la clasificación de Clavien-Dindo modificada para complicaciones postoperatorias en cirugía ortopédica Validación de la clasificación de Clavien-Dindo modificada para complicaciones postoperatorias en cirugía ortopédica Camino Willhuber, Gaston Slullitel, Pablo Taype Zamboni, Danilo Albergo, Jose Terrasa, Sergio Piuzzi, Nicolas Boretto, Jorge postoperative complications orthopedics health systems complicaciones posoperatorias ortopedia sistemas de salud complicações pós-operatórias ortopedia sistemas de saúde Introduction: Postoperative complications (PCs) constitute any deviation from the normal postoperative course. Reporting of PCs remains a challenge, multiple classification systems have been proposed, however these have not been validated across surgical specialties. Clavien and Dindo (DCCS) developed a system for General Surgery and has been adopted in different fields. Nonetheless, this classification has not been adapted to Orthopedics. The objective of this study was to adapt the Clavien-Dindo classification to orthopedic scenarios and to determine the intra and interobserver reliability. Methods: The designer team adapted the Clavien Dindo classification to orthopedic scenarios. Ten orthopedic observers with different degrees of training and experience were selected to evaluate the classification. 48 simulated clinical scenarios of complications and another negative outcomes such as failure to cure and sequelae were sent by electronic format independently. A second round of scoring was performed 30 days later to assess the intraobserver concordance. Results: We found a high interobserver and intraobserver reliability for both the first and second evaluation (Kappa 0.88 and 0.91, respectively). In addition, the intraobserver analysis showed a very good correlation (Kappa 0.93). Discussion: The DCCS classification has been developed for general surgery and has been widely applied in the different surgical subspecialties. In Orthopedics, this classification was validated to hip and pediatric surgery. Therefore, our study involved an adaptation of the classification to general and specific orthopedic scenarios of the different orthopedic subspecialties. This classification may be a useful tool for documenting complications in orthopedic surgery. Keywords: postoperative complications; orthopedics; health systems Introducción: Las complicaciones postoperatorias constituyen cualquier desviación del estado postoperatorio normal. El registro de las mismas sigue siendo un desafío, se han propuesto múltiples sistemas de clasificación, sin embargo, estos no han sido validados en todas las especialidades quirúrgicas. Clavien y Dindo desarrollaron un sistema para Cirugía General y ha sido adoptado en diferentes campos. Sin embargo, esta clasificación no se ha adaptado a la ortopedia. El objetivo de este estudio fue adaptar la clasificación de Clavien-Dindo a los escenarios ortopédicos y determinar la confiabilidad intra e interobservador. Materiales y Métodos: Se adaptó la clasificación de Clavien Dindo a los escenarios ortopédicos. Diez observadores con diferentes grados de entrenamiento y experiencia fueron seleccionados para evaluar la clasificación. Se enviaron 48 escenarios clínicos simulados de complicaciones y otros resultados negativos en formato electrónico de forma independiente. Se realizó una segunda ronda de puntuación 30 días después para evaluar la concordancia intraobservador. Resultados: Encontramos una alta confiabilidad interobservador e intraobservador tanto para la primera como para la segunda evaluación (Kappa 0.88 y 0.91, respectivamente). Además, el análisis intraobservador mostró una muy buena correlación (Kappa 0,93). Discusión: La clasificación Clavien-Dindo se ha desarrollado para cirugía general y se ha aplicado ampliamente en las diferentes subespecialidades quirúrgicas. En ortopedia, esta clasificación fue validada para cirugías de cadera y pediátrica. Por lo tanto, nuestro estudio implicó una adaptación de la clasificación a escenarios ortopédicos generales y específicos de las diferentes subespecialidades ortopédicas. Esta clasificación puede ser una herramienta útil para documentar complicaciones en cirugía ortopédica. Palabras claves: complicaciones posoperatorias; ortopedia; sistema de salud Introdução: As complicações pós-operatórias constituem qualquer desvio do estado pós-operatório normal. O registro destes permanece um desafio, vários sistemas de classificação foram propostos, no entanto, estes não foram validados em todas as especialidades cirúrgicas. Clavien e Dindo desenvolveram um sistema para Cirurgia Geral e foram adotados em diferentes áreas. No entanto, essa classificação não foi adaptada à ortopedia. O objetivo deste estudo foi adaptar a classificação de Clavien-Dindo aos cenários ortopédicos e determinar a confiabilidade intra e interobservadores. Materiais e Métodos: A classificação de Clavien Dindo foi adaptada aos cenários ortopédicos. Dez observadores com diferentes graus de treinamento e experiência foram selecionados para avaliar o ranking. 48 cenários clínicos simulados de complicações e outros resultados negativos foram enviados eletronicamente de forma independente. Uma segunda rodada de pontuação foi realizada 30 dias depois para avaliar a concordância intraobservador. Resultados: Encontramos alta confiabilidade interobservador e intraobservador para a primeira e a segunda avaliação (Kappa 0,88 e 0,91, respectivamente). Além disso, a análise intraobservador mostrou uma correlação muito boa (Kappa 0,93). Discussão: A classificação de Clavien-Dindo foi desenvolvida para cirurgia geral e tem sido amplamente aplicada nas diferentes subespecialidades cirúrgicas. Na ortopedia, essa classificação foi validada para cirurgias de quadril e pediatria. Portanto, nosso estudo envolveu uma adaptação da classificação a cenários ortopédicos gerais e específicos das diferentes subespecialidades ortopédicas. Essa classificação pode ser uma ferramenta útil para documentar complicações em cirurgia ortopédica. Palavras-chave: complicações pós-operatórias; ortopedia; sistema de saúde Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2020-08-21 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf text/html https://revistas.unc.edu.ar/index.php/med/article/view/27931 10.31053/1853.0605.v77.n3.27931 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 77 No. 3 (2020); 161-167 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 77 Núm. 3 (2020); 161-167 Revista da Faculdade de Ciências Médicas de Córdoba; v. 77 n. 3 (2020); 161-167 1853-0605 0014-6722 10.31053/1853.0605.v77.n3 eng https://revistas.unc.edu.ar/index.php/med/article/view/27931/31060 https://revistas.unc.edu.ar/index.php/med/article/view/27931/30717 Derechos de autor 2020 Universidad Nacional de Córdoba https://creativecommons.org/licenses/by-nc/4.0 |