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ASSESSMENT OF POSTOPERATIVE COMPLICATIONS AFTER SURGERY USING THE CLAVIEN-DINDO CLASSIFICATION AND THE COMPREHENSIVE COMPLICATION INDEX (CCI) AT UNIVERSITY MEDICAL CENTER HO CHI MINH CITY
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Abstract
Objective: To assess postoperative adverse events and complications following surgery and invasive procedures at University Medical Center Ho Chi Minh City in 2024 using the Clavien-Dindo classification and the Comprehensive Complication Index (CCI®) based on electronic medical record (EMR) data. Materials and methods: A cross-sectional descriptive study retrospectively reviewed EMR data for all surgical and procedural cases performed at the hospital from 01 January to 31 December 2024. Complications were recorded during the index hospitalization for the intervention, graded according to Clavien-Dindo (highest grade per case), and summarized using the CCI® (incorporating all complications). Results: A total of 40,384 cases were included. Overall, 604/40,384 cases experienced ≥1 complication (1.50%). The distribution of Clavien–Dindo grades was: grade I 0.74%, grade II 0.26%, grade IIIa 0.08%, grade IIIb 0.22%, grade IV 0.09%, and grade V 0.11%. Among cases with complications, the mean CCI was 30.5 ± 27.7 and the median was 20.9 (8.7–100). Specialties with notable median CCI and/or complication rates included Cardiac Surgery (CCI 58.4; 5.71%), Hepato-Pancreato-Biliary Surgery (29.6; 2.54%), Thoracic and Vascular Surgery (29.6; 1.67%), Gastrointestinal Surgery (12.2; 3.92%), and Neurosurgery (12.2; 1.99%). Age ≥60 years, ASA class ≥3, multiple medical comorbidities, and “special-category” procedures were significantly associated with higher CCI scores (p<0.0001). Conclusion: The simultaneous application of the Clavien-Dindo classification and the CCI® based on electronic medical record data enables a detailed hospital-wide characterization of postoperative adverse events and complications following surgery/procedures, while also facilitating the identification of high-risk specialties/procedure groups and associated factors to support clinical quality surveillance.
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Keywords
Clavien-Dindo classification; Comprehensive Complication Index; postoperative complications; invasive procedures.
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