Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug;272(2):220-226.
doi: 10.1097/SLA.0000000000003897.

Development and Evaluation of a Novel Instrument to Measure Severity of Intraoperative Events Using Video Data

James J Jung  1   2 , Peter Jüni  3 , Denise W Gee  4 , Yulia Zak  5 , Joslin Cheverie  6 , Jin S Yoo  7 , John M Morton  8 , Teodor Grantcharov  1   2
Affiliations

Development and Evaluation of a Novel Instrument to Measure Severity of Intraoperative Events Using Video Data

James J Jung et al. Ann Surg. 2020 Aug.

Abstract

Objective: To develop and evaluate a novel instrument to measure SEVERE processes using video data.

Background: Surgical video data can serve an important role in understanding the relationship between intraoperative events and postoperative outcomes. However, a standard tool to measure severity of intraoperative events is not yet available.

Methods: Items to be included in the instrument were identified through literature and video reviews. A committee of experts guided item reduction, including pilot tests and revisions, and determined weighted scores. Content validity was evaluated using a validated sensibility questionnaire. Inter-rater reliability was assessed by calculating intraclass correlation coefficient. Construct validity was evaluated on a sample of 120 patients who underwent laparoscopic Roux-en-Y gastric bypass procedure, in which comprehensive video data was obtained.

Results: SEVERE index measures severity of 5 event types using ordinal scales. Each intraoperative event is given a weighted score out of 10. Inter-rater reliability was excellent [0.87 (95%-confidence interval, 0.77-0.92)]. In a sample of consecutive 120 patients undergoing gastric bypass procedures, a median of 12 events [interquartile range (IQR) 9-18] occurred per patient and bleeding was the most frequent type (median 10, IQR 7-14). The median SEVERE score per case was 11.3 (IQR 8.3-16.9). In risk-adjusted multivariable regression models, history of previous abdominal surgery (P = 0.02) and body mass index (P = 0.005) were associated with SEVERE scores, demonstrating construct validity evidence.

Conclusion: The SEVERE index may prove to be a useful instrument in identifying patients with high risk of developing postoperative complications.

PubMed Disclaimer

Comment in

References

    1. Knops AM, Legemate DA, Goossens A, et al. Decision aids for patients facing a surgical treatment decision: a systematic review and meta-analysis. Ann Surg 2013; 257:860–866.
    1. Wright CD, Kucharczuk JC, O’Brien SM, et al. Predictors of major morbidity and mortality after esophagectomy for esophageal cancer: a Society of Thoracic Surgeons General Thoracic Surgery Database risk adjustment model. J Thorac Cardiovasc Surg 2009; 137:587–595. discussion 596.
    1. Park DJ, Lee HJ, Kim HH, et al. Predictors of operative morbidity and mortality in gastric cancer surgery. Br J Surg 2005; 92:1099–1102.
    1. Livingston EH, Huerta S, Arthur D, et al. Male gender is a predictor of morbidity and age a predictor of mortality for patients undergoing gastric bypass surgery. Ann Surg 2002; 236:576–582.
    1. Bilimoria KY, Liu Y, Paruch JL, et al. Development and evaluation of the universal ACS NSQIP surgical risk calculator: a decision aid and informed consent tool for patients and surgeons. J Am Coll Surg 2013; 217:833–842.e1-3.

MeSH terms