Severity of Postoperative Complications From the Perspective of the Patient

Abstract

Background: Although provider-derived surgical complication severity grading systems exist, little is known about the patient perspective. Objective: To assess patient-rated complication severity and determine concordance with existing grading systems. Methods: A survey asked general surgery patients to rate the severity of 21 hypothetical postoperative events representing grades 1 to 5 complications from the Accordion Severity Grading System. Concordance with the Accordion scale was examined. Separately, descriptive ratings of 18 brief postoperative events were ranked. Results: One hundred sixty-eight patients returned a mailed survey following their discharge from a general surgery service. Patients rated grade 4 complications highest. Grade 1 complications were rated similarly to grade 5 and higher than grades 2 and 3 ( P ≤ .01). Patients rated one event not considered an Accordion scale complication higher than all but grade 4 complications ( P < .001). The brief events also did not follow the Accordion scale, other than the grade 6 complication ranking highest. Conclusion: Patient-rated complication severity is discordant with provider-derived grading systems, suggesting the need to explore important differences between patient and provider perspectives.

How Women Perceive Severity of Complications after Pelvic Floor Repair?

“…The degree of pain, and particularly dyspareunia that can impact a woman's sexual quality of life, emerged as a strong determinant for classifying the severity of the complication. This confirms the work by Rendell et al who assessed the concordance between patient perception and a complication scale, and found that the level of pain was a determining factor of patient perception of complication severity [12].…”

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