A Systematic Review of Intra- and Postoperative Complication Reporting and Grading in Urological Surgery: Understanding the Pitfalls and a Path Forward

Soliman, Christopher; Sathianathen, Niranjan; Thomas, Benjamin; Giannarini, Gianluca; Lawrentschuk, Nathan; Wuethrich, Patrick Y.; Dundee, Philip; Nair, Rajesh; Furrer, Marc A.

doi:10.1016/j.euo.2023.01.002

Cited by 4 publications

(2 citation statements)

References 31 publications

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“…More than 60% of all postoperative complications were not reported, and the accuracy of reported complications was only 33.3%. According to the literature, under-reporting of postoperative complications is a well-documented problem in surgery [22][23][24][25][26]. Several studies have shown that the true incidence of postoperative complications is often higher compared to the numbers reported in medical records and published studies [27,28].…”

Section: Discussionmentioning

confidence: 99%

Incidence of postoperative complications is underestimated if outcome data are recorded by interns and first year residents in a low volume hospital setting

Raguz,

Meissner,

Ahlen

et al. 2023

Preprint

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Quality of outcome measurement in a district hospital is poor if done by unexperienced residents and significantly underestimates the true complication rate. Outcome measurement must be done or supervised by experienced surgeons to ensure correct and reliable outcome data. The aim of this study is to evaluate the accuracy of outcome reporting after elective visceral surgery in a low volume district hospital. Outcome measurement as well as transparent reporting of surgical complications becomes more and more important. In the future, financial and personal resources may be distributed due to reported quality and thus, it is in the main interest of healthcare providers that outcome data are accurately collected. Between 10/ 2020 and 09/ 2021 postoperative complications during the hospitalisation were recorded using the Clavien - Dindo classification (CDC) and comprehensive complication index (CCIâ) by residents of a surgical department in a district hospital. After one year of prospective data collection, data were retrospectively analyzed and re-evaluated for accuracy by senior consultant surgeons. In 575 patients undergoing elective general or visceral surgery interns and residents reported an overall rate of patients with complications of 7.3% (n=42) during the hospitalization phase, whereas a rate of 18.3% (n=105) was revealed after retrospective analysis by senior consultant surgeons. Thus, residents failed to report postoperative complications in 60% of cases (63/105). In the 42 cases, in which complications were initially reported, the grading of complications was correct only in 33.3% of cases (n=14). Complication grades that were most missed were CDC grade I and II.

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Section: Discussionmentioning

confidence: 99%

Incidence of postoperative complications is underestimated if outcome data are recorded by interns and first year residents in a low volume hospital setting

Raguz,

Meissner,

Ahlen

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…It also highlights that we need to be better at tracking and recording complications and then auditing and changing behaviors. 3,4 Many instances of iatrogenic catheter injury will “just” cause pain and not stricture—few, unless they result in some type of upscaled maneuver (cystoscopy, calling urologist in to catheterize, operating theater for washout), will make it onto unit data. Further, morbidity with doing catheterizations multiple times, especially if a patient is in retention, should not be discounted—these become etched in their mind and define their whole hospital experience.…”

mentioning

confidence: 99%