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) devel...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Universidad Nacional de Córdoba
2020-08-01
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| Series: | Revista de la Facultad de Ciencias Médicas de Córdoba |
| Subjects: | |
| Online Access: | https://revistas.unc.edu.ar/index.php/med/article/view/27931 |
| _version_ | 1818865023931383808 |
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| author | Gaston Camino Willhuber Pablo Slullitel Danilo Taype Zamboni Jose Albergo Sergio Terrasa Nicolas Piuzzi Jorge Boretto |
| author_facet | Gaston Camino Willhuber Pablo Slullitel Danilo Taype Zamboni Jose Albergo Sergio Terrasa Nicolas Piuzzi Jorge Boretto |
| author_sort | Gaston Camino Willhuber |
| collection | DOAJ |
| 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 |
| first_indexed | 2024-12-19T10:40:58Z |
| format | Article |
| id | doaj.art-d93438315e7b4c54ba446dec633f1ee8 |
| institution | Directory Open Access Journal |
| issn | 0014-6722 1853-0605 |
| language | English |
| last_indexed | 2024-12-19T10:40:58Z |
| publishDate | 2020-08-01 |
| publisher | Universidad Nacional de Córdoba |
| record_format | Article |
| series | Revista de la Facultad de Ciencias Médicas de Córdoba |
| spelling | doaj.art-d93438315e7b4c54ba446dec633f1ee82022-12-21T20:25:27ZengUniversidad Nacional de CórdobaRevista de la Facultad de Ciencias Médicas de Córdoba0014-67221853-06052020-08-0177310.31053/1853.0605.v77.n3.2793125167Validation of a modified Clavien-Dindo Classification for postoperative complications in orthopedic surgeryGaston Camino Willhuber0Pablo Slullitel1Danilo Taype Zamboni2Jose Albergo3Sergio Terrasa4Nicolas Piuzzi5Jorge Boretto6Hospital Italiano de Buenos AiresHospital Italiano de Buenos AiresHospital Italiano de Buenos AiresHospital Italiano de Buenos AiresHospital Italiano de Buenos AiresCleveland ClinicHospital Italiano de Buenos AiresIntroduction: 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 systemshttps://revistas.unc.edu.ar/index.php/med/article/view/27931postoperative complicationsorthopedicshealth systems |
| spellingShingle | Gaston Camino Willhuber Pablo Slullitel Danilo Taype Zamboni Jose Albergo Sergio Terrasa Nicolas Piuzzi Jorge Boretto Validation of a modified Clavien-Dindo Classification for postoperative complications in orthopedic surgery Revista de la Facultad de Ciencias Médicas de Córdoba postoperative complications orthopedics health systems |
| title | 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_short | 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 |
| topic | postoperative complications orthopedics health systems |
| url | https://revistas.unc.edu.ar/index.php/med/article/view/27931 |
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