Use of Clavien-Dindo Classification System in Assessing Head and Neck Surgery Complications

Abstract

Improving quality of postoperative surgical care in head and neck surgery requires reporting of complications. Clavien-Dindo classification system can be used in grading complications related to head and neck surgery and to assess interobserver variability in grading complex complication scenarios. Data was collected from 242 patients who underwent Head and Neck Surgery from 2015 to 2018 at Dept. of ENT and Head and Neck Surgery at a tertiary care hospital. 177 patients had complications were graded based on Clavien-Dindo classification system, into a 5-scale classification system. Interobserver reliability scores for the complication grading scenarios were found to be statistically significant. Construct validity was confirmed as the length of stay in the hospital was statistically related to complication grade (P = 0.032) Reporting of complications is critical to quality improvement in surgical practice. The Clavien-Dindo complication grading scale system was found to be a useful tool for grading head and neck surgery complications.

Keywords: Clavien classification; Head and neck; Quality improvement; Surgical complications.

Fig. 1

First and second observer grading of complications according to Clavien Dindo severity. Series 1 represents first observer grading, series 2 represents second observer grading of complications (n represents no. of complications)

Fig. 2

Various head and neck surgeries and their complications. Figure showing various head and neck surgeries and their complications (n represents no. of complications)

Fig. 3

Mean length of stay plotted against Clavien–Dindo Severity. Figure showing mean length of hospital stay with grade of complication (n represents mean length of hospital stay)