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
Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.
Faculty of Medicine, University of Zurich, Zurich, Switzerland.
Front Surg. 2021 Feb 18;8:638057. doi: 10.3389/fsurg.2021.638057. eCollection 2021.
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. 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. Seventy-seven otolaryngologists responded to the survey. Mean subjective rating and surgical complication grading for each scenario showed an inverse correlation ( = 0.147, = 0.044). When grading the surgical complication with respect to the surgical indication, the correlation with the subjective rating increased dramatically ( = 0.307, = 0.0022). 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.
Clavien-Dindo分类是一种广泛接受的手术并发症分类系统，根据解决并发症所需的治疗程度对并发症进行分级。该方法的一个缺点是它没有考虑患者最初接受手术的原因。我们基于Clavien-Dindo设计了一个新的指标，但考虑了手术指征。我们对一个国际耳鼻喉科医生小组进行了调查，他们填写了一份包含32个受真实病例启发的情景的问卷。每个病例都根据手术并发症、手术指征以及并发症是否可接受进行主观评分。77名耳鼻喉科医生回复了调查。每个情景的平均主观评分和手术并发症分级呈负相关（r = 0.147，P = 0.044）。当根据手术指征对手术并发症进行分级时，与主观评分的相关性显著增加（r = 0.307，P = 0.0022）。我们描述了一个根据手术指征对手术并发症进行分级的新指标。在我们的调查中，大多数受访者根据并发症的分级判断其是否可接受，但会考虑手术指征。这种主观判断可以用我们的新指标进行量化。
