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

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


Journalwits journal of clinical medicine
Article typeJournal research article – Clinical research
Publication date – Mar – 2021
Authors – Maeyane Stephens Moeng, Anna Sparaco, Irma Mare, Veneshree Naidoo, Boitumelo Phakathi, Eloise Juliet Miller, Thomas Kekgatleope Marumo, Uzayr Khan, Taalib Monareng, Thifhelimbilu Emmanuel Luvhengo
KeywordsClavien-Dindo (CD), post-operative complications, standard deviation
Open access – Yes
SpecialityGeneral surgery
World region Southern Africa
Country: South Africa
Language – English
Submitted to the One Surgery Index on March 19, 2021 at 10:30 pm
Abstract:

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.

OSI Number – 20964

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