Spinal Adverse Events Severity System, version 2 (SAVES-V2): inter- and intraobserver reliability assessment

Rampersaud, Y. Raja; Anderson, Paul A.; Dimar, John R.; Fisher, Charles G.

doi:10.3171/2016.1.spine14808

Cited by 67 publications

(60 citation statements)

References 38 publications

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“…Different definitions and classifications of complications by different investigators make difficult to compare studies. The Clavien-Dindo and SAVES capture and grading systems [25][26][27] divide the severity of surgical complications into levels based on the grade of treatment required to face the complication. Complications were categorized as major or minor by Glassman et al Significant complications requiring reoperation or leading to permanent deficit were considered major complications.…”

Section: Collection and Classification Of Spinal Surgery Complicationsmentioning

confidence: 99%

“…We divided the complications into seven categories: hematoma, infection, cerebrospinal fluid (CSF) leakage or fistula, mechanical complications, neurological damages, systemic complications, and surgeryrelated death. This is probably the main weakness of the study: As the collection of complications started using a non-standardized system inserted in the hospital medical charts, any known classification system (as Glassman's, Clavien-Dindo's or SAVES systems) was used [25][26][27][28]; this probably caused an underestimation of the number of complications captured.…”

Section: Collection and Classification Of Spinal Surgery Complicationsmentioning

confidence: 99%

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Spinal surgery complications: an unsolved problem—Is the World Health Organization Safety Surgical Checklist an useful tool to reduce them?

et al. 2019

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Purpose To investigate whether the World Health Organization Safety Surgical Checklist (SSC) is an effective tool to reduce complications in spinal surgery. Methods We retrospectively evaluated the clinical and radiological charts prospectively collected from patients who underwent a spinal surgery procedure from January 2010 to December 2012. The aim of this study was to compare the incidence of complications between two periods, from January to December 2010 (without checklist) and from January 2011 and December 2012 (with checklist), in order to assess the checklist's effectiveness. Results The sample size was 917 patients with an average of 30-month follow-up. The mean age was 52.88 years. The majority of procedures were performed for oncological diseases (54.4%) and degenerative diseases (39.8%). In total, 159 complications were detected (17.3%). The overall incidence of complications for trauma, infectious pathology, oncology, and degenerative disease was 22.2%, 19.2%, 18.4%, and 15.3%, respectively. No correlation was observed between the type of pathology and the complication incidence. We observed a reduction in the overall incidence of complications following the introduction of the SSC: In 2010 without checklist, the incidence of complications was 24.2%, while in 2011 and 2012, following the checklist introduction, the incidence of complications was 16.7% and 11.7%, respectively (mean 14.2%). Conclusions The SSC seems to be an effective tool to reduce complications in spinal surgery. We propose to extend the use of checklist system also to the preoperative and postoperative phases in order to further reduce the incidence of complications.

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Section: Collection and Classification Of Spinal Surgery Complicationsmentioning

confidence: 99%

Section: Collection and Classification Of Spinal Surgery Complicationsmentioning

confidence: 99%

Spinal surgery complications: an unsolved problem—Is the World Health Organization Safety Surgical Checklist an useful tool to reduce them?

et al. 2019

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“…In addition to the wide array of diverse procedures available in spinal surgery, adverse event reporting has been made challenging due to the terms "adverse events," "complications," "unexpected outcomes," and "iatrogenic injuries" being poorly defined and commonly used interchangeably in the literature. [68][69][70][71][72] Several recent systematic reviews have commented on the inconsistency in the description of adverse events, its severity, and a lack of standardized reporting in spine related clinical research studies. [73][74][75] Moreover, the presence of underreporting and underestimation further diminishes appreciation for the full spectrum and incidence of adverse events.…”

Section: Reporting Of Adverse Eventsmentioning

confidence: 99%

Quality and Safety Improvement in Spine Surgery

Jiang

Wilson

Badhiwala

et al. 2020

Global Spine Journal

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Study Design: Review article. Objectives: A narrative review of the literature on the current advances and limitations in quality and safety improvement initiatives in spine surgery. Methods: A comprehensive literature search was performed using Ovid MEDLINE focusing on 3 preidentified concepts: (1) quality and safety improvement, (2) reporting of outcomes and adverse events, and (3) prediction model and practice guidelines. The search was conducted under appropriate subject headings and using relevant text words. Articles were screened, and manuscripts relevant to this discussion were included in the narrative review. Results: Quality and safety improvement remains a major research focus attracting investigators from the global spine community. Multiple databases and registries have been developed for the purpose of generating data and monitoring the progress of quality and safety improvement initiatives. The development of various prediction models and clinical practice guidelines has helped shape the care of spine patients in the modern era. With the reported success of exemplary programs initiated by the Northwestern and Seattle Spine Team, other quality and safety improvement initiatives are anticipated to follow. However, despite these advancements, the reporting metrics for outcomes and adverse events remain heterogeneous in the literature. Conclusion: Constant surveillance and continuous improvement of the quality and safety of spine treatments is imperative in modern health care. Although great advancement has been made, issues with reporting outcomes and adverse events persist, and improvement in this regard is certainly needed.

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“…However, at a basic level, a standard language and consistent definitions for what constitutes an adverse event (AE) have been lacking [11]. Current terminology, such as ''complication,'' ''AE,'' ''adverse occurrence,'' or ''near misses,'' are often used interchangeably, but have different meanings (between or within institutions depending on case definition) and varying methods for identification and reporting [10]. In addition, concerns regarding malpractice, professional, and financial implications (personal, practice group, or institutional) of AEs can result in variable reporting of AEs [7].…”

mentioning

confidence: 99%

“…Specific to the current article by Chen and colleagues, underreporting of AEs by physicians is one of the evidentiary challenges in patient-safety initiatives [12]. Chen and colleagues prospectively assessed the use of a Spinal Adverse Events Severity System (SAVES) (developed by this writer) for spine and orthopaedic surgery [10,11]. They demonstrated relative under-reporting by surgeons regarding minor AEs and appropriately questioned the cost-benefit of using third-party reviewers.…”

mentioning

confidence: 99%

CORR Insights®: Can Surgeons Adequately Capture Adverse Events Using the Spinal Adverse Events Severity System (SAVES) and OrthoSAVES?

Rampersaud

2017

Clinical Orthopaedics &Amp; Related Research

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Spinal Adverse Events Severity System, version 2 (SAVES-V2): inter- and intraobserver reliability assessment

Cited by 67 publications

References 38 publications

Spinal surgery complications: an unsolved problem—Is the World Health Organization Safety Surgical Checklist an useful tool to reduce them?

Spinal surgery complications: an unsolved problem—Is the World Health Organization Safety Surgical Checklist an useful tool to reduce them?

Quality and Safety Improvement in Spine Surgery

CORR Insights®: Can Surgeons Adequately Capture Adverse Events Using the Spinal Adverse Events Severity System (SAVES) and OrthoSAVES?

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