Clavien–Dindo classification of post-operative complications in a South African setting

MS Moeng, A Sparaco, I Mare, V Naidoo… - Wits Journal of Clinical …, 2021 - journals.co.za
MS Moeng, A Sparaco, I Mare, V Naidoo, B Phakathi, EJ Miller, TK Marumo, U Khan…
Wits Journal of Clinical Medicine, 2021journals.co.za
Background: Clavien-Dindo (CD) classification is used to standardize the reporting of post-
operative complications. The aim of the study was to report our initial experience following
the adoption of the use of CD classification for reporting of post-operative complications
across surgical specialities. Methods: An audit of prospectively collected data, from records
of patients aged 18 years and older who had surgery, was conducted. Data collected
included patients' demographics, acuity of operations, types of surgery, recorded post …
Background
Clavien-Dindo (CD) classification is used to standardize the reporting of post-operative complications. The aim of the study was to report our initial experience following the adoption of the use of CD classification for reporting of post-operative complications across surgical specialities.
Methods
An audit of prospectively collected data, from records of patients aged 18 years and older who had surgery, was conducted. Data collected included patients' demographics, acuity of operations, types of surgery, recorded post-operative complications and assigned CD class. Categorical variables were summarized using frequency and percentages. The mean with standard deviation (SD) was used for the aggregation of continuous data. χ2-test or Fisher's exact test was used to compare categorical findings. The strength of associations was measured using Cramer's V and the φ coeficient. Data analysis was carried out using the SAS version 9.4 for Windows. The level of significance was set at a P value below 0.05.
Results
A total of 3399 surgical procedures were performed, of which 1700 (50.0%) were emergencies. The mean (± SD) age of operated patients was 44.3 (±16.7) years. eThre were 11.2% post-operative complications of which 65.8% were directly related to surgical procedures. Approximately 48.1% of the complications were infections. The CD classicfiation was applied to the complications, of which 31.6% were categorized as Grade I and 26.3% as Grade IIIb. There was a significant but weak association between reported complication types and surgical specialty (P < 0.0001; Cramer's V = 0.25), and between the reported grade of complications and surgical specialty (P < 0.0001; Cramer's V = 0.21). Overall mortality was 7.7%.
Conclusions
The CD classification was adopted by all specialties studied. The rate of post-operative complications was 11%, the majority of which were infections. Reported grades of complications were influenced by surgical specialty. A high number of Grade IIIb complications were recorded than have been previously reported.
Sabinet African Journals
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