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Accepted for/Published in: JMIR Perioperative Medicine

Date Submitted: May 27, 2022
Date Accepted: Sep 22, 2022

The final, peer-reviewed published version of this preprint can be found here:

Definition and Classification of Postoperative Complications After Cardiac Surgery: Pilot Delphi Study

Lapp L, Bouamrane MM, Roper M, Kavanagh K, Schraag S

Definition and Classification of Postoperative Complications After Cardiac Surgery: Pilot Delphi Study

JMIR Perioper Med 2022;5(1):e39907

DOI: 10.2196/39907

PMID: 36222812

PMCID: 9607909

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Definition and Classification of Postoperative Complications After Cardiac Surgery: A Pilot Delphi Study

  • Linda Lapp; 
  • Matt-Mouley Bouamrane; 
  • Marc Roper; 
  • Kimberley Kavanagh; 
  • Stefan Schraag

ABSTRACT

Background:

Postoperative complications following cardiac surgery are common and represent a serious burden to health services and society. However, there is a lack of consensus among experts on what events should be considered as a ‘complication’ and how to assess their ‘severity’.

Objective:

This study aimed to consult domain experts to pilot a development of a definition and classification system for complications following cardiac surgery with the goal to allow the progression of standardized clinical processes and systems in cardiac surgery.

Methods:

We conducted a Delphi study, which is a well-established method to reach expert consensus on complex topics. Two rounds of surveys were sent out to domain experts, including cardiac surgeons and anesthetists, to define and classify postoperative complications following cardiac surgery. The responses to open-ended questions were analyzed using a thematic analysis framework.

Results:

In total, N=71 and N=37 experts’ opinion were included in the analysis in Round 1 and Round 2 of the study, respectively. Experts agreed that a classification of postoperative complications for cardiac surgery is useful, and a consensus was reached for the generic definition of a postoperative complication in cardiac surgery. Consensus was also reached on classification of complications according to the following 4 levels: “Mild”, “Moderate”, “Severe” and “Death”, and consensus was also reached on a definition of “Mild” and “Severe” categories of complications.

Conclusions:

Domain experts agreed on the definition and classification of complications in cardiac surgery. The standardization of complication identification, recording and reporting in cardiac surgery should help the development of quality benchmarks, clinical audit, care quality assessment, resources planning, risk management, communication, and research.


 Citation

Please cite as:

Lapp L, Bouamrane MM, Roper M, Kavanagh K, Schraag S

Definition and Classification of Postoperative Complications After Cardiac Surgery: Pilot Delphi Study

JMIR Perioper Med 2022;5(1):e39907

DOI: 10.2196/39907

PMID: 36222812

PMCID: 9607909

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