Review Article | | Peer-Reviewed

Application of Clavien-Dindo Complications Classification in Cardiac Surgery Practice: A Narrative Review

Received: 12 April 2024    Accepted: 3 May 2024    Published: 17 May 2024
Views:       Downloads:
Abstract

Background: Cardiac surgery is a complex medical specialty known for its potential complications, necessitating accurate evaluation and reporting. Current prediction scales have limitations in capturing the full spectrum of complications experienced by patients undergoing cardiac surgery. The Clavien-Dindo Complications Classification (CDCC) and the Comprehensive Complications Index (CCI) have emerged as promising tools for assessing complications in various surgical specialties, including cardiac surgery. Method: This comprehensive review synthesizes the available literature to assess the application of CDCC and CCI in the context of cardiac surgery. The effectiveness of CDCC and CCI in measuring the nature and clinical impact of complications in this specialized field is explored. Additionally, methods from other medical specialties are reviewed to enhance our understanding of the practical implementation of these classification systems in cardiac surgery. Results: The present study, including significant contributions by Mélanie Hébert et al., highlights the potential of CDCC and CCI to quantify both the number and severity of complications in adult cardiac surgery. Their utility in this specialized field presents opportunities for robust data collection and outcome evaluation. Conclusion: While the application of CDCC and CCI in cardiac surgery shows promise, the notable scarcity of comprehensive evaluation studies has hindered the accessibility of these systems to clinicians. This study provides a clear and accessible reference for healthcare professionals seeking to integrate CDCC and CCI into their cardiac surgery practice. Additionally, we propose the need for guideline studies to address this gap in the field.

Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 10, Issue 1)
DOI 10.11648/j.ijcts.20241001.12
Page(s) 6-13
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Cardiac Surgery, Clavien-Dindo Complications Classification (CDCC), Comprehensive Complications Index (CCI)

References
[1] Udzik J, Sienkiewicz S, Biskupski A, Szylińska A, Kowalska Z, Biskupski P. Cardiac Complications Following Cardiac Surgery Procedures. J Clin Med. 2020; 9(10).
[2] Sinha S, Dimagli A, Dixon L, Gaudino M, Caputo M, Vohra HA, Angelini G, Benedetto U. Systematic review and meta-analysis of mortality risk prediction models in adult cardiac surgery. Interactive CardioVascular and Thoracic Surgery. 2021; 33(5): 673-686.
[3] Bolliger M, Kroehnert JA, Molineus F, Kandioler D, Schindl M, Riss P. Experiences with the standardized classification of surgical complications (Clavien-Dindo) in general surgery patients. Eur Surg. 2018; 50(6): 256-261.
[4] Katayama H, Kurokawa Y, Nakamura K, Ito H, Kanemitsu Y, Masuda N, Tsubosa Y, Satoh T, Yokomizo A, Fukuda H, Sasako M. Extended Clavien-Dindo classification of surgical complications: Japan Clinical Oncology Group postoperative complications criteria. Surg Today. 2016; 46(6): 668-685.
[5] Mitropoulos D, Artibani W, Biyani CS, Bjerggaard Jensen J, Rouprêt M, Truss M. Validation of the Clavien-Dindo Grading System in Urology by the European Association of Urology Guidelines Ad Hoc Panel. Eur Urol Focus. 2018; 4(4): 608-613.
[6] Degerli MS, Canturk AO, Bozkurt H, Alpay O, Akinci M, Altundal YE, Yildiz T, Yildirim D. Systematic assessment of complications after laparoscopic colorectal surgery for advanced colorectal cancer: A retrospective study using Clavien-Dindo classification, 5-year experience. Malawi Med J. 2022; 34(1): 49-52.
[7] Hébert M, Cartier R, Dagenais F, Langlois Y, Coutu M, Noiseux N, El-Hamamsy I, Stevens LM. Standardizing Postoperative Complications-Validating the Clavien-Dindo Complications Classification in Cardiac Surgery. Semin Thorac Cardiovasc Surg. 2021; 33(2): 443-451.
[8] Wang WG, Babu SR, Wang L, Chen Y, Tian BL, He HB. Use of Clavien-Dindo classification in evaluating complications following pancreaticoduodenectomy in 1,056 cases: A retrospective analysis from one single institution. Oncol Lett. 2018; 16(2): 2023-2029.
[9] Golder H, Casanova D, Papalois V. Evaluation of the usefulness of the Clavien-Dindo classification of surgical complications. Cir Esp (Engl Ed). 2023; 101(9): 637-642.
[10] Idriss AM, Tfeil Y, Baba JS, Boukhary SM, Deddah MA. [Applicability of the Clavien-Dindo classification in the evaluation of postoperative complications at the Surgery Department of the National Hospital Center of Nouakchott: observational study of 834 cases]. Pan Afr Med J. 2019; 33254.
[11] Slankamenac K, Graf R, Barkun J, Puhan MA, Clavien PA. The comprehensive complication index: a novel continuous scale to measure surgical morbidity. Ann Surg. 2013; 258(1): 1-7.
[12] Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004; 240(2): 205-213.
[13] Yoon PD, Chalasani V, Woo HH. Use of Clavien-Dindo classification in reporting and grading complications after urological surgical procedures: analysis of 2010 to 2012. J Urol. 2013; 190(4): 1271-1274.
[14] Hébert M, Cartier R, El-Hamamsy I, Dagenais F, Langlois Y, de Varennes B, Greentree D, Stevens L. AN ADAPTED CLAVIEN-DINDO CLASSIFICATION AND COMPREHENSIVE COMPLICATIONS INDEX RELIABLY REPRESENT EARLY POSTOPERATIVE OUTCOMES IN CARDIAC SURGERY. Canadian Journal of Cardiology. 2019; 35(10): S165.
[15] Vail EA, Shieh MS, Pekow PS, Gershengorn HB, Walkey AJ, Lindenauer PK, Wunsch H. Use of Vasoactive Medications after Cardiac Surgery in the United States. Ann Am Thorac Soc. 2021; 18(1): 103-111.
[16] Schoonen A, van Klei WA, van Wolfswinkel L, van Loon K. Definitions of low cardiac output syndrome after cardiac surgery and their effect on the incidence of intraoperative LCOS: A literature review and cohort study. Front Cardiovasc Med. 2022; 9926957.
[17] Hajjar LA, Vincent J-L, Galas FRBG, Nakamura RE, Silva CMP, Santos MH, Fukushima J, Filho RK, Sierra DB, Lopes NH, et al. Transfusion Requirements After Cardiac Surgery: The TRACS Randomized Controlled Trial. JAMA. 2010; 304(14): 1559-1567.
[18] Engoren MC, Habib RH, Zacharias A, Schwann TA, Riordan CJ, Durham SJ. Effect of blood transfusion on long-term survival after cardiac operation. The Annals of Thoracic Surgery. 2002; 74(4): 1180-1186.
[19] Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibañes E, Pekolj J, Slankamenac K, Bassi C, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009; 250(2): 187-196.
[20] Dekker A, Crawford HA, Stott NS. How Do Complications Within the First 30 days after Spinal Deformity Surgery in Children with Cerebral Palsy Affect Length of Stay? Clin Orthop Relat Res. 2021; 479(2): 366-375.
[21] Smeyers K, Slankamenac K, Houben B, Sergeant G. Comparison of the Clavien-Dindo and Comprehensive Complication Index systems for grading of surgical complications after colorectal resections. Acta Chir Belg. 2022; 122(6): 403-410.
[22] Kim T-H, Suh Y-S, Huh Y-J, Son Y-G, Park J-H, Yang J-Y, Kong S-H, Ahn HS, Lee H-J, Slankamenac K, et al. The comprehensive complication index (CCI) is a more sensitive complication index than the conventional Clavien–Dindo classification in radical gastric cancer surgery. Gastric Cancer. 2018; 21(1): 171-181.
Cite This Article
  • APA Style

    Thuan, P. Q. (2024). Application of Clavien-Dindo Complications Classification in Cardiac Surgery Practice: A Narrative Review. International Journal of Cardiovascular and Thoracic Surgery, 10(1), 6-13. https://doi.org/10.11648/j.ijcts.20241001.12

    Copy | Download

    ACS Style

    Thuan, P. Q. Application of Clavien-Dindo Complications Classification in Cardiac Surgery Practice: A Narrative Review. Int. J. Cardiovasc. Thorac. Surg. 2024, 10(1), 6-13. doi: 10.11648/j.ijcts.20241001.12

    Copy | Download

    AMA Style

    Thuan PQ. Application of Clavien-Dindo Complications Classification in Cardiac Surgery Practice: A Narrative Review. Int J Cardiovasc Thorac Surg. 2024;10(1):6-13. doi: 10.11648/j.ijcts.20241001.12

    Copy | Download

  • @article{10.11648/j.ijcts.20241001.12,
      author = {Phan Quang Thuan},
      title = {Application of Clavien-Dindo Complications Classification in Cardiac Surgery Practice: A Narrative Review
    },
      journal = {International Journal of Cardiovascular and Thoracic Surgery},
      volume = {10},
      number = {1},
      pages = {6-13},
      doi = {10.11648/j.ijcts.20241001.12},
      url = {https://doi.org/10.11648/j.ijcts.20241001.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20241001.12},
      abstract = {Background: Cardiac surgery is a complex medical specialty known for its potential complications, necessitating accurate evaluation and reporting. Current prediction scales have limitations in capturing the full spectrum of complications experienced by patients undergoing cardiac surgery. The Clavien-Dindo Complications Classification (CDCC) and the Comprehensive Complications Index (CCI) have emerged as promising tools for assessing complications in various surgical specialties, including cardiac surgery. Method: This comprehensive review synthesizes the available literature to assess the application of CDCC and CCI in the context of cardiac surgery. The effectiveness of CDCC and CCI in measuring the nature and clinical impact of complications in this specialized field is explored. Additionally, methods from other medical specialties are reviewed to enhance our understanding of the practical implementation of these classification systems in cardiac surgery. Results: The present study, including significant contributions by Mélanie Hébert et al., highlights the potential of CDCC and CCI to quantify both the number and severity of complications in adult cardiac surgery. Their utility in this specialized field presents opportunities for robust data collection and outcome evaluation. Conclusion: While the application of CDCC and CCI in cardiac surgery shows promise, the notable scarcity of comprehensive evaluation studies has hindered the accessibility of these systems to clinicians. This study provides a clear and accessible reference for healthcare professionals seeking to integrate CDCC and CCI into their cardiac surgery practice. Additionally, we propose the need for guideline studies to address this gap in the field.
    },
     year = {2024}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Application of Clavien-Dindo Complications Classification in Cardiac Surgery Practice: A Narrative Review
    
    AU  - Phan Quang Thuan
    Y1  - 2024/05/17
    PY  - 2024
    N1  - https://doi.org/10.11648/j.ijcts.20241001.12
    DO  - 10.11648/j.ijcts.20241001.12
    T2  - International Journal of Cardiovascular and Thoracic Surgery
    JF  - International Journal of Cardiovascular and Thoracic Surgery
    JO  - International Journal of Cardiovascular and Thoracic Surgery
    SP  - 6
    EP  - 13
    PB  - Science Publishing Group
    SN  - 2575-4882
    UR  - https://doi.org/10.11648/j.ijcts.20241001.12
    AB  - Background: Cardiac surgery is a complex medical specialty known for its potential complications, necessitating accurate evaluation and reporting. Current prediction scales have limitations in capturing the full spectrum of complications experienced by patients undergoing cardiac surgery. The Clavien-Dindo Complications Classification (CDCC) and the Comprehensive Complications Index (CCI) have emerged as promising tools for assessing complications in various surgical specialties, including cardiac surgery. Method: This comprehensive review synthesizes the available literature to assess the application of CDCC and CCI in the context of cardiac surgery. The effectiveness of CDCC and CCI in measuring the nature and clinical impact of complications in this specialized field is explored. Additionally, methods from other medical specialties are reviewed to enhance our understanding of the practical implementation of these classification systems in cardiac surgery. Results: The present study, including significant contributions by Mélanie Hébert et al., highlights the potential of CDCC and CCI to quantify both the number and severity of complications in adult cardiac surgery. Their utility in this specialized field presents opportunities for robust data collection and outcome evaluation. Conclusion: While the application of CDCC and CCI in cardiac surgery shows promise, the notable scarcity of comprehensive evaluation studies has hindered the accessibility of these systems to clinicians. This study provides a clear and accessible reference for healthcare professionals seeking to integrate CDCC and CCI into their cardiac surgery practice. Additionally, we propose the need for guideline studies to address this gap in the field.
    
    VL  - 10
    IS  - 1
    ER  - 

    Copy | Download

Author Information
  • Sections