+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

The comprehensive complication index (CCI) is a more sensitive complication index than the conventional Clavien-Dindo classification in radical gastric cancer surgery

The comprehensive complication index (CCI) is a more sensitive complication index than the conventional Clavien-Dindo classification in radical gastric cancer surgery

Gastric Cancer 21(1): 171-181

The comprehensive complication index (CCI) integrates all complications of the Clavien-Dindo classification (CDC) and offers a metric approach to measure morbidity. The aim of this study was to evaluate the CCI at a high-volume center for gastric cancer surgery and to compare the CCI to the conventional CDC. Clinical factors were collected from the prospective complication data of gastric cancer patients who underwent radical gastrectomy at Seoul National University Hospital from 2013 to 2014. CDC and CCI were calculated, and risk factors were investigated. Correlations and generalized linear models of hospital stay were compared between the CCI and CDC. The complication monitoring model with cumulative sum control-CCI (CUSUM-CCI) was displayed for individual surgeons, for comparisons between surgeons, and for the institution. From 1660 patients, 583 complications in 424 patients (25.5%) were identified. The rate of CDC grade IIIa or greater was 9.7%, and the overall CCI was 5.8 ± 11.7. Age, gender, Charlson score, combined resection, open method, and total gastrectomy were associated with increased CCI (p < 0.05). The CCI demonstrated a stronger relationship with hospital stay (ρ = 0.721, p < 0.001) than did the CDC (ρ = 0.634, p < 0.001). For prolonged hospital stays (≥30 days), only the CCI showed a moderate correlation (ρ = 0.544, p = 0.024), although the CDC did not. The CUSUM-CCI model displayed dynamic time-event differences in individual and comparison monitoring models. In the institution monitoring model, a gradual decrease in the CCI was observed. The CCI is more strongly correlated with postoperative hospital stay than is the conventional CDC. The CUSUM-CCI model can be used for the continuous monitoring of surgical quality.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 060333905

Download citation: RISBibTeXText

PMID: 28597328

DOI: 10.1007/s10120-017-0728-3

Related references

Toward a More Sensitive Endpoint for Assessing Postoperative Complications in Patients with Inflammatory Bowel Disease: a Comparison Between Comprehensive Complication Index (CCI) and Clavien-Dindo Classification (CDC). Journal of Gastrointestinal Surgery 2018, 2018

A novel comprehensive complication index by Clavien in patients with radical prostatectomy. European Urology Suppl.s 14(2): e661-e661b, 2015

Reliability of the Modified Clavien-Dindo-Sink Complication Classification System in Pediatric Orthopaedic Surgery. Jb and Js Open Access 3(4): E0020, 2019

Laparoscopic sleeve gastrectomy at a new bariatric surgery centre in Canada: 30-day complication rates using the Clavien-Dindo classification. Canadian Journal of Surgery. Journal Canadien de Chirurgie 59(2): 93-97, 2016

Novel application of the Clavien-Dindo classification system and the comprehensive complications index in microvascular free tissue transfer to the head and neck. Oral Oncology 94: 21-25, 2019

Clavien-Dindo classification and risk factors for complications after radical gastrectomy for gastric cancer. Zhonghua Yi Xue Za Zhi 93(46): 3667-3670, 2014

Risk factors associated with complication following gastrectomy for gastric cancer: retrospective analysis of prospectively collected data based on the Clavien-Dindo system. Journal of Gastrointestinal Surgery 18(7): 1269-1277, 2015

Standardizing the complication rate after breast reduction using the Clavien-Dindo classification. Surgery 161(5): 1430-1435, 2017

Complication rates of open transvesical prostatectomy according to the Clavien-Dindo classification system. Nigerian Journal of Clinical Practice 15(1): 34-37, 2012

A Quantified Scoring System for Postoperative Complication Severity Compared to the Clavien-Dindo Classification. Digestive Surgery 32(5): 361-366, 2016

The Uro-Clavien–Dindo system—Will the limitations of the Clavien–Dindo system for grading complications of urological surgery allow modification of the classification to encourage national adoption within the UK?. British Journal of Medical and Surgical Urology 5(2): 54-60, 2012

Modified frailty index associated with Clavien-Dindo IV complications in robot-assisted radical prostatectomies: A retrospective study. Urologic Oncology 35(6): 425-431, 2017

Influence of HIV virus in the hospital stay and the occurrence of postoperative complications classified according to the Clavien-Dindo classification and in comparison with the Charlson Comorbidity Index in patients subjected to urologic and general surgery operations. Our preliminary results. Archivio Italiano di Urologia, Andrologia 89(2): 125-129, 2017

Comprehensive Complication Index Predicts Cancer-Specific Survival of Patients with Postoperative Complications after Curative Resection of Gastric Cancer. Gastroenterology Research and Practice 2018: 4396018-4396018, 2018

Evaluation of Clavien-Dindo classification in patients undergoing total gastrectomy for gastric cancer. Medical Oncology 32(4): 120, 2016