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.
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