Application of the comprehensive complication index and Clavien-Dindo complication classification in cardiac surgery: a retrospective study.

BACKGROUND

Standardized tools are needed to accurately assess the severity of postoperative complications in cardiac surgery, which is critical for patient management and outcome evaluation. This study aims to evaluate the application of the Clavien Dindo Complications Classification (CDCC) and Comprehensive Complications Index (CCI) in cardiac surgery.

RESULTS

563 patients (76.3%) had at least one complication. The mean CCI was 22.5 ± 19.3. Patients who underwent more complex surgeries had higher CDCC grades and CCI scores. Hospitalization cost and length of stay increased with increasing CDCC grade and CCI score. The ACCI (OR: 1.334 [1.109-1.606], p = 0.002) and LVEF (OR: 0.965 [0.943-0.987], p = 0.002) were associated factors for the most severe complications. The CCI may reduce the required sample size by 20.5 times and 19.6 times compared with the most severe complication or major adverse cardiovascular and cerebrovascular events, respectively, as an endpoint.

CONCLUSION

The CCI and CDCC can help reflect the complexity of cardiac surgery and the burden of hospitalization, providing a more accurate assessment of surgical complications. This may reduce the sample size needed for clinical trials, thus facilitating research in cardiac surgery.

CLINICAL TRIAL REGISTRATION

Chinese Clinical Trial Registry (No. ChiCTR2400084925) on May 28th, 2024. https://www.chictr.org.cn/showproj.html?proj=228499 .