Comparison of the Clavien-Dindo and Comprehensive Complication Index systems for grading of surgical complications after colorectal resections. Issue 6 (2nd November 2022)

• Record Type: Journal Article
• Authors: Smeyers, Karel Marie Celine Ivo; Slankamenac, Ksenija; Houben, Bert; Sergeant, Gregory
• Is Part Of: Acta chirurgica belgica. Volume 122:Issue 6(2022)
• Page Start: 403
• Page End: 410
• Publication Date: 2022-11-02
• Subjects: Clavien-Dindo classification -- Comprehensive Complication Index -- colorectal resections -- postoperative complications -- socio-economic impact of complications; Surgery -- Periodicals; General Surgery; Chirurgie -- Périodiques; Surgery; Chirurgie (geneeskunde); Periodicals; Periodicals; 617.005
• DOI: 10.1080/00015458.2021.1920682
• Languages: English
• ISSNs: 0001-5458

Abstract

Abstract: Introduction: Postoperative complications are associated with prolonged hospital stay and a rise in costs of treatment. The Comprehensive Complication Index (CCI) was developed as a scoring system that does not only take the most severe complication into account but all complications after surgery. Our aim was to compare the Clavien-Dindo scoring system with the CCI in predicting length of hospital stay (LOHS) and in-hospital costs after colorectal resections. Methods: Complications occurring after surgical procedures, performed between October 2012 and September 2013, were prospectively recorded. During this period 164 patients developed complication(s). Only patients that underwent a colorectal resection were included. Multivariable linear regression analysis was performed to find independent predictors of in-hospital costs and LOHS. Results: 64 patients (age (range): 69 (10–91) years, M/F: 36/28) were retained. 46 (71.9%) patients had a Clavien-Dindo score ≥ IIIb. Median (IQR) CCI was 40 (30.2–53.9). Mean (±SD) in-hospitals costs for all patients were €12, 920 ± €10, 229. The adjusted difference (95% CI, p -value) in in-hospital costs for minor and major (Clavien-Dindo ≥ IIIb) complications was 10, 021 (€4283 to €15, 759, p = 0.001). A 10 point increase in CCI increased in-hospital costs by €2040. Multivariable analysis retained CCI > 40 as the only independent risk factor for increased in-hospital costs (Standard Beta Coeffic ( p -value): 8063 ( p = 0.022). Conclusion: CCI is a better predictor of in-hospital costs than Clavien-Dindo score to classify complications after colorectal resections, as it captures all complications. Further research is warranted to extrapolate our findings to other sub-specialities of surgery.