Published online Jun 21, 2019. doi: 10.3748/wjg.v25.i23.2833
Peer-review started: March 22, 2019
First decision: April 5, 2019
Revised: April 11, 2019
Accepted: April 19, 2019
Article in press: April 21, 2019
Published online: June 21, 2019
Postoperative complications represent a basic quality indicator for measuring outcomes at surgical units. At present, however, they are not systematically measured in all surgical procedures. A more accurate assessment of their impact could help to evaluate the real morbidity associated with different surgical interventions, establish measures for improvement, increase efficiency and identify benchmarking services. The Clavien-Dindo Classification is the most widely used system worldwide for assessing postoperative complications. However, the postoperative period is summarized by the most serious complication without taking into account others of lesser magnitude. Recently, two new scoring systems have emerged, the Comprehensive Complication Index and the Complication Severity Score, which include all postoperative complications and quantify them from 0 (no complications) to 100 (patient’s death), These allow the comparison of results. It is important to train surgical staff to report and classify complications and to record 90-d morbidity rates in all patients. Comparisons with other services must take into account patient comorbidities and the complexity of the particular surgical procedure. To avoid subjectivity and bias, external audits are necessary. In addition, ensuring transparency in the reporting of the results is an urgent obligation.
Core tip: Postoperative complications represent a basic quality indicator for measuring surgical outcomes, but at present they are not systematically recorded. A more thorough assessment of their impact could help to determine the real morbidity, establish measures for improvement, increase efficiency and identify benchmarking services. The use of the Clavien Dindo Classification of Complications and the Comprehensive Complication Index would allow us to compare them. Surgical staff must be encouraged to report and classify complications and to record 90-d morbidity rates in all patients. External audits are necessary, and ensuring transparency in the reporting of the results is an urgent obligation.