Dear colleagues,
there are a few classification systems for complications / adverse events (AEs) that can be applied to spine-surgery. Most are generic and base on a combination of the treatment required to manage the AE and case-fatality, as originally proposed by Clavien & Dindo (1). Only few classifications are specific for spine-surgery, implement items relevant to AEs in spine care (e.g. pain, disability) and have been thoroughly validated.(2,3,4) None of the prior classification systems is simple but comprehensive, grades the severity of an AE in a way that is intuitive & corresponds to the impact on the patient’s quality of life.
Based on a systematic literature review (according to PRISMA guidelines) identifying prior classification systems for AEs in spine surgery, members of the AO Spine ESA study group leads, the AO Spine Knowledge Forum "Degenerative", the EANS Spine Section and the Eurospine Research Council agreed on a common grading scale to evaluate AEs in a semi-quantitative way, assigning a score value from 0 (no impact on the patient) to 10 (death or extremely negative impact). It incorporates relevant items from identified previous classifications and complements beyond. The so-called “Complication Severity Scale” (CSS) was reviewed and approved by patients having undergone spine surgery, as well as by nonprofit patient associations.
Now, we would like to ask you to evaluate the reliability & validity of the CSS using an online survey including 18 case vignettes that will need to be filled out twice (again 6 weeks after the initial survey). Participation is voluntary and takes about 30min. The data collected is anonymous, but participants who fully complete both surveys, provide the necessary personal data and agreement will be listed as collaborators (indexed in MEDLINE/PubMed for all publications). The collaborator agreement formular will be provided in the second part of the survey. We do not collect any other identifying information such as IP address. We did not receive any funding for this study.
If you have any questions about this study, please contact Martin N. Stienen (mnstienen@gmail.com).
References:
1) 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):205-13. doi: 10.1097/01.sla.0000133083.54934.ae
2) Rampersaud YR, Neary MA, White K. Spine adverse events severity system: content validation and interobserver reliability assessment. Spine (Phila Pa 1976) 2010;35(7):790-5. doi: 10.1097/BRS.0b013e3181bf25a3
3) Farshad M, Aichmair A, Gerber C, et al. Classification of perioperative complications in spine surgery. Spine J 2020;20(5):730-36. doi: 10.1016/j.spinee.2019.12.013 [published Online First: 20191223]
4) Glassman SD, Hamill CL, Bridwell KH, et al. The impact of perioperative complications on clinical outcome in adult deformity surgery. Spine (Phila Pa 1976) 2007;32(24):2764-70. doi: 10.1097/BRS.0b013e31815a7644
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