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Comprehensive Complication Index or Clavien–Dindo Classification: Which is Better for Evaluating the Severity of Postoperative Complications Following Pancreatectomy?

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Abstract

Background

Complications are important indicators of immediate postoperative outcomes. The Clavien–Dindo classification (CDC) is a widely used index for the classification of surgical complications. More recently, the comprehensive complication index (CCI) has also been introduced for classifying postoperative complications. The aim of this study was to compare the relationship of CCI and CDC with clinical or economic parameters.

Methods

The study prospectively enrolled patients from April 2015 to October 2016. Two hundred and twenty-two patients underwent pancreatectomy during the enrolled period. Complications were ranked according to CDC and CCI indices. After analyzing the correlation between CCI and CDC, the correlations of length of stay (LOS) and cost with CCI and CDC were compared. Finally, differences between the correlation coefficients of CDC and CCI parameters were calculated.

Results

Complications occurred in 211 patients (95.0%). The correlation between CDC and CCI was r = 0.938. (p < 0.001) Compared to the CDC, CCI showed significantly stronger correlations with LOS and cost of complications (LOS: CCI vs. CDC, r = 0.725 vs. r = 0.630, p < 0.001; cost: CCI vs. CDC, r = 0.774 vs. r = 0.723, p < 0.001).

Conclusion

CCI is a more accurate classification index, compared to CDC, for evaluating the risk of postoperative complications.

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Authors and Affiliations

  1. Department of Hepatobiliary and Pancreatic Surgery, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea

    Sung Hyun Kim, Ho Kyoung Hwang, Woo Jung Lee & Chang Moo Kang

  2. Pancreatobiliary Cancer Center, Yonsei Cancer Center, Severance Hospital, Seoul, Korea

    Sung Hyun Kim, Ho Kyoung Hwang, Woo Jung Lee & Chang Moo Kang

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  1. Sung Hyun Kim
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  2. Ho Kyoung Hwang
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Correspondence to Chang Moo Kang.

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Informed consent was obtained from all individual participants included in the study.

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Kim, S.H., Hwang, H.K., Lee, W.J. et al. Comprehensive Complication Index or Clavien–Dindo Classification: Which is Better for Evaluating the Severity of Postoperative Complications Following Pancreatectomy?. World J Surg 45, 849–856 (2021). https://doi.org/10.1007/s00268-020-05859-7

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  • DOI: https://doi.org/10.1007/s00268-020-05859-7

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