Severity Grading Systems for Intraoperative Adverse Events. A Systematic Review of the Literature and Citation Analysis.

Humans Intraoperative Complications / diagnosis Bibliometrics

Journal

Annals of surgery
ISSN: 1528-1140
Titre abrégé: Ann Surg
Pays: United States
ID NLM: 0372354

Informations de publication

Date de publication:
01 11 2023
Historique:
medline: 6 10 2023
pubmed: 15 5 2023
entrez: 15 5 2023
Statut: ppublish

Résumé

The accurate assessment and grading of adverse events (AE) is essential to ensure comparisons between surgical procedures and outcomes. The current lack of a standardized severity grading system may limit our understanding of the true morbidity attributed to AEs in surgery. The aim of this study is to review the prevalence in which intraoperative adverse event (iAE) severity grading systems are used in the literature, evaluate the strengths and limitations of these systems, and appraise their applicability in clinical studies. A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. PubMed, Web of Science, and Scopus were queried to yield all clinical studies reporting the proposal and/or the validation of iAE severity grading systems. Google Scholar, Web of Science, and Scopus were searched separately to identify the articles citing the systems to grade iAEs identified in the first search. Our search yielded 2957 studies, with 7 studies considered for the qualitative synthesis. Five studies considered only surgical/interventional iAEs, while 2 considered both surgical/interventional and anesthesiologic iAEs. Two included studies validated the iAE severity grading system prospectively. A total of 357 citations were retrieved, with an overall self/nonself-citation ratio of 0.17 (53/304). The majority of citing articles were clinical studies (44.1%). The average number of citations per year was 6.7 citations for each classification/severity system, with only 2.05 citations/year for clinical studies. Of the 158 clinical studies citing the severity grading systems, only 90 (56.9%) used them to grade the iAEs. The appraisal of applicability (mean%/median%) was below the 70% threshold in 3 domains: stakeholder involvement (46/47), clarity of presentation (65/67), and applicability (57/56). Seven severity grading systems for iAEs have been published in the last decade. Despite the importance of collecting and grading the iAEs, these systems are poorly adopted, with only a few studies per year using them. A uniform globally implemented severity grading system is needed to produce comparable data across studies and develop strategies to decrease iAEs, further improving patient safety.

Identifiants

DOI: 10.1097/SLA.0000000000005883 PMID: 37185890
pubmed: 37185890
doi: 10.1097/SLA.0000000000005883
pii: 00000658-202311000-00039
doi:

Types de publication

Systematic Review Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e973-e980

Informations de copyright

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

Références

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Auteurs

Aref S Sayegh (AS)

Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA.

Michael Eppler (M)

Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA.

Tamir Sholklapper (T)

Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Department of Urology, Einstein Healthcare Network, Philadelphia, PA.

Mitchell G Goldenberg (MG)

Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA.

Laura C Perez (LC)

Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
ORCID: 0000-0002-9799-0594

Anibal La Riva (A)

Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Department of General Surgery, Digestive Disease & Surgery Institute, Cleveland Clinic Foundation, Cleveland, OH.
ORCID: 0000-0003-2198-833

Luis G Medina (LG)

Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA.
ORCID: 0000-0002-4188-7096

Rene Sotelo (R)

Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA.

Mihir M Desai (MM)

Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA.

Inderbir Gill (I)

Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA.

James J Jung (JJ)

Department of Surgery, University of Toronto, Toronto, ON, Canada.

Airazat M Kazaryan (AM)

Department of Surgery, Østfold Hospital Trust, Gralum, Norway.
Institute for Clinical Medicine, University of Oslo, Oslo, Norway.
Department of Surgery, Fonna Hospital Trust, Odda, Norway.
Department of Surgery N 1, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia.
Department of Faculty Surgery N 2, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.

Bjørn Edwin (B)

Institute for Clinical Medicine, University of Oslo, Oslo, Norway.
Intervention Centre and Department of Hepatopancreatobiliary Surgery, Oslo University Hospital - Rikshospitalet, Oslo, Norway.

Chandra Shekhar Biyani (CS)

St James's University Hospital, Leeds, UK.

Nader Francis (N)

The Griffin Institute, Division of Surgery and Interventional Science-UCL, London, UK.

Haytham Ma Kaafarani (HM)

Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston, MA.

Giovanni E Cacciamani (GE)

Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA.

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