Key result
Agreement between the Clavien-Dindo and ISOS classification systems for grading postoperative complication severity was poor overall (ICC 0.41; 95% CI 0.20-0.55).
Why the study?
It was unclear whether the Clavien-Dindo classification, which grades postoperative complication severity by treatment provided, can be used internationally across differing healthcare systems in high- and low- and middle-income countries.
Does the Clavien-Dindo classification agree with the ISOS grading system for postoperative complications across different healthcare systems?
Population
44 814 elective surgery adult patients across 474 hospitals in 27 countries
Comparison
Clavien-Dindo classification vs ISOS grading system
Design
Secondary analysis of a prospective observational cohort study
Follow-up
7-day period
Authors
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Caution advised comparing postoperative complications across systems in global surgery; leaves open need for standardized metrics.
Cohort (n=44,814)
Yes
Does the Clavien-Dindo classification agree with the ISOS grading system for postoperative complications across different healthcare systems?
Effect estimate: ICC 0.41 (95% CI 0.20 to 0.55)
The Clavien-Dindo classification shows poor agreement with a simpler clinical grading system in global surgery studies, suggesting caution when using treatment-based complication grading across diverse healthcare settings.
Abbott et al. (2019) conducted a cohort in Elective surgery (n=44,814). Clavien-Dindo classification vs. ISOS grading was evaluated on Agreement between classification systems for grading severity of postoperative complications (ICC 0.41, 95% CI 0.20 to 0.55). Agreement between the Clavien-Dindo and ISOS classification systems for grading postoperative complication severity was poor overall (ICC 0.41; 95% CI 0.20-0.55).
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