The Intraoperative Complications Assessment and Reporting with Universal Standards (ICARUS) Global Surgical Collaboration Project: Development of Criteria for Reporting Adverse Events During Surgical Procedures and Evaluating Their Impact on the Postoperative Course

Cacciamani, Giovanni; Sholklapper, Tamir; Dell’Oglio, Paolo; Rocco, Bernardo; Annino, Filippo; Antonelli, Alessandro; Amenta, Michele; Borghesi, Marco; Bove, Pierluigi; Bozzini, Giorgio; Cafarelli, Angelo; Celia, Antonio; Leonardo, Costantino; Ceruti, C.; Cindolo, Luca; Crivellaro, Simone; Dalpiaz, Orietta; Falabella, R.; Falsaperla, Mario; Galfano, Antonio; F, Gallo; Greco, F.; Minervini, Andrea; Parma, P.; Sighinolfi, Maria Chiara; Pastore, Antonio Luigi; Pini, G.; Porreca, Angelo; Pucci, Luigi; Sciorio, Carmine; Schiavina, Riccardo; Umari, Paolo; Varca, Virginia; Veneziano, Domenico; Verze, Paolo; Volpe, Alessandro; Zaramella, S.; Lebastchi, Amir H.; Abreu, Andre Luis; Mitropoulos, Dionysios; Biyani, Chandra Shekhar; Sotelo, René; Desai, Mihir; Artibani, Walter; Gill, Inderbir S.

doi:10.1016/j.euf.2022.01.018

Cited by 49 publications

(32 citation statements)

References 72 publications

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“…The surgical community has already started looking at barriers and experiences related to iAE reporting 1. In collaboration with a global cohort of leaders in surgical quality and safety, we plan to take this even further establishing the Intraoperative Complications As-sessment and Reporting with Universal Standards (ICARUS) Global Surgical Collaboration 10. We have designed and will soon implement a cross-specialty, multi-national survey of experiences and opinions regarding iAE reporting (ClinicalTrials.gov; NCT049943920).…”

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confidence: 99%

Standardizing The Intraoperative Adverse Events Assessment to Create a Positive Culture of Reporting Errors in Surgery and Anesthesiology

Cacciamani¹,

Sholklapper²,

Dell-Kuster³

et al. 2022

Annals of Surgery

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A B FIGURE 1. Citations of postoperative (A) and intraoperative (B) adverse event classifications systems over the last decade. Web of Science citation search (09/2021) comparing the usage of standardized postoperative and intraoperative events in clinical studies. The Clavien-Dindo classification system is cited in clinical research trials at approximately 270-times the rate of all intraoperative event classification systems combined

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confidence: 99%

Standardizing The Intraoperative Adverse Events Assessment to Create a Positive Culture of Reporting Errors in Surgery and Anesthesiology

Cacciamani¹,

Sholklapper²,

Dell-Kuster³

et al. 2022

Annals of Surgery

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“…Precise monitoring of complications has been proven to improve quality of care and to contribute to the improvement of clinical standards. [14][15][16] Therefore, it is important for surgeons to acquire the knowledge of complication monitoring and to learn how to implement it into clinical practice.…”

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confidence: 99%

Classification of Adverse Events in Adult Surgery

2023

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Successful surgery combines quality (achievement of a positive outcome) with safety (avoidance of a negative outcome). Outcome assessment serves the purpose of quality improvement in health care by establishing performance indicators and allowing the identification of performance gaps. Novel surgical quality metric tools (benchmark cutoffs and textbook outcomes) provide procedure-specific ideal surgical outcomes in a subgroup of well-defined low-risk patients, with the aim of setting realistic and best achievable goals for surgeons and centers, as well as supporting unbiased comparison of surgical quality between centers and periods of time. Validated classification systems have been deployed to grade adverse events during the surgical journey: (1) the ClassIntra classification for the intraoperative period; (2) the Clavien–Dindo classification for the gravity of single adverse events; and the (3) Comprehensive Complication Index (CCI) for the sum of adverse events over a defined postoperative period. The failure to rescue rate refers to the death of a patient following one or more potentially treatable postoperative adverse event(s) and is a reliable proxy of the institutional safety culture and infrastructure. Complication assessment is undergoing digital transformation to decrease resource-intensity and provide surgeons with real-time pre- or intraoperative decision support. Standardized reporting of complications informs patients on their chances to realize favorable postoperative outcomes and assists surgical centers in the prioritization of quality improvement initiatives, multidisciplinary teamwork, surgical education, and ultimately, in the enhancement of clinical standards.

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“…Choosing the appropriate outcome reporting system is critical in order to achieve these goals and doing so successfully has the potential to foster a positive culture of adverse event (AE) reporting and accurate data comparison. Ultimately, such a collaboration between the surgical community could translate into improved patient outcomes by precisely capturing surgical events that lead to patient harm and develop measures to prevent them from happening [ 2 , 3 , 4 ].…”

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confidence: 99%

“…Properly reporting AEs in academic literature is essential for understanding the true incidence and impact of these events on patient safety and outcomes. Therefore, the Intraoperative Complication Assessment and Reporting with Universal Standards (ICARUS) Global Surgical Collaboration is working on providing the resources needed to accelerate the worldwide adoption and rigorous implementation of a culture of assessment, collection, grading, and reporting of iAEs [ 2 , 3 , 4 , 20 , 21 , 22 ]. Such collaboration should increase the quality of research, which in turn has lasting implications for how we approach medical academia and surgical and anesthesiologic care for patients.…”

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confidence: 99%

Strategies for Improving the Standardization of Perioperative Adverse Events in Surgery and Anesthesiology: “The Long Road from Assessment to Collection, Grading and Reporting”

Sayegh

Eppler

Ballon

et al. 2022

JCM

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The Intraoperative Complications Assessment and Reporting with Universal Standards (ICARUS) Global Surgical Collaboration Project: Development of Criteria for Reporting Adverse Events During Surgical Procedures and Evaluating Their Impact on the Postoperative Course

Cited by 49 publications

References 72 publications

Standardizing The Intraoperative Adverse Events Assessment to Create a Positive Culture of Reporting Errors in Surgery and Anesthesiology

Standardizing The Intraoperative Adverse Events Assessment to Create a Positive Culture of Reporting Errors in Surgery and Anesthesiology

Classification of Adverse Events in Adult Surgery

Strategies for Improving the Standardization of Perioperative Adverse Events in Surgery and Anesthesiology: “The Long Road from Assessment to Collection, Grading and Reporting”

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