医学
分级(工程)
引用
梅德林
系统回顾
不利影响
普通外科
重症监护医学
内科学
图书馆学
计算机科学
政治学
工程类
土木工程
法学
作者
Aref S. Sayegh,Michael Eppler,Tamir Sholklapper,Mitchell G. Goldenberg,Laura Crespo Pérez,Anibal La Riva,Luis G. Medina,René Sotelo,Mihir Desai,Inderbir S. Gill,James J. Jung,Airazat М. Kazaryan,Bjørn Edwin,Chandra Shekhar Biyani,Nader Francis,Haytham M.A. Kaafarani,Giovanni Cacciamani
出处
期刊:Annals of Surgery
[Ovid Technologies (Wolters Kluwer)]
日期:2023-04-27
卷期号:278 (5): e973-e980
被引量:6
标识
DOI:10.1097/sla.0000000000005883
摘要
The accurate assessment and grading of adverse events (AE) is essential to ensure comparisons between surgical procedures and outcomes. The current lack of a standardized severity grading system may limit our understanding of the true morbidity attributed to AEs in surgery. The aim of this study is to review the prevalence in which intraoperative adverse event (iAE) severity grading systems are used in the literature, evaluate the strengths and limitations of these systems, and appraise their applicability in clinical studies.A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. PubMed, Web of Science, and Scopus were queried to yield all clinical studies reporting the proposal and/or the validation of iAE severity grading systems. Google Scholar, Web of Science, and Scopus were searched separately to identify the articles citing the systems to grade iAEs identified in the first search.Our search yielded 2957 studies, with 7 studies considered for the qualitative synthesis. Five studies considered only surgical/interventional iAEs, while 2 considered both surgical/interventional and anesthesiologic iAEs. Two included studies validated the iAE severity grading system prospectively. A total of 357 citations were retrieved, with an overall self/nonself-citation ratio of 0.17 (53/304). The majority of citing articles were clinical studies (44.1%). The average number of citations per year was 6.7 citations for each classification/severity system, with only 2.05 citations/year for clinical studies. Of the 158 clinical studies citing the severity grading systems, only 90 (56.9%) used them to grade the iAEs. The appraisal of applicability (mean%/median%) was below the 70% threshold in 3 domains: stakeholder involvement (46/47), clarity of presentation (65/67), and applicability (57/56).Seven severity grading systems for iAEs have been published in the last decade. Despite the importance of collecting and grading the iAEs, these systems are poorly adopted, with only a few studies per year using them. A uniform globally implemented severity grading system is needed to produce comparable data across studies and develop strategies to decrease iAEs, further improving patient safety.
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