Kaafarani et al developed a classification scheme for intraoperative adverse events. Proper classification of adverse events can improve tracking and preventive measures. The authors are from Massachusetts General Hospital.
Parameters:
(1) surgical repair required (suture, patch, etc)
(2) organ or tissue removal (resection)
(3) change in originally planned procedure (excluding conversion from minimally invasive to open procedure)
(4) detection
(5) intraoperative death
(6) blood transfusion secondary to injury
Parameter |
Class |
delayed detection (missed during surgery) AND re-operation within 7 days |
V |
intraoperative death |
VI |
blood transfusion >= 2 units |
add "T" as suffix |
where:
• An adverse event not requiring re-operation within 7 days would be unclassified. This would involve (a) no reoperation and (b) detection after 7 days.
• A blood transfusion would be unlikely for a minor adverse event.
Surgical Repair |
Organ/Tissue Removal |
Change in Procedure |
Class |
NA |
NA |
Yes |
IV |
NA |
Yes |
No |
III |
Yes |
No |
No |
II |
No |
No |
No |
I |
where:
• Organ or tissue removal could cover quite a spectrum.
Classes I and II are considered minor while Classes III to VI as major.
ICD-10: ,