Observational studyThe journal of trauma and acute care surgery2017
An adapted Clavien-Dindo scoring system in trauma as a clinically meaningful nonmortality endpoint.
Observational study in The journal of trauma and acute care surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Impact of blunt adrenal gland injury (BAGI) in major trauma: a systematic review and meta-analysis.World journal of emergency surgery : WJES · 2026Pooled it
- Multi-Modal Analgesic Strategy for Trauma: A Pragmatic Randomized Clinical Trial.Journal of the American College of Surgeons · 2021Trial
- Patterns of negative trauma laparotomy worldwide: a sub-analysis of a global dataset.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Observational
- Inflatable penile prosthesis implantation performed by residents after a structured training pathway.BJU international · 2025Article
- Article
- Assessing the outcomes and complications of abdominal trauma using the adapted Clavien-Dindo in trauma scoring system in a tertiary hospital: an observational study.Journal of trauma and injury · 2025Article
- Applying enhanced recovery principles to emergency laparotomy in penetrating abdominal trauma: a case-matched study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Article
- Trauma Registry: Trauma Quality indicators analysis in hospitalized patients.Revista do Colegio Brasileiro de Cirurgioes · 2024Article
- Could trauma laparoscopy be the standard of care for hemodynamically stable patients? A retrospective analysis of 165 cases.Surgical endoscopy · 2023Article
- Comorbidities, injury severity and complications predict mortality in thoracic trauma.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Article
- Survival and neurologic outcomes following aortic occlusion for trauma and hemorrhagic shock in a hybrid operating room.World journal of emergency surgery : WJES · 2023Article
- Survival and neurologic outcomes following aortic occlusion for trauma and hemorrhagic shock in a hybrid operating room.Research square · 2023Article
- Validation of the adapted clavien dindo in trauma (ACDiT) scale to grade management related complications at a level I trauma center.Turkish journal of surgery · 2022Article
- [Digital documentation of complications in visceral surgery: possibilities and evaluation of an instrument for quality management].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2022Article
- Article
- In-Hospital Clinical Outcomes in Patients with Fragility Fractures of the Lumbar Spine, Thoracic Spine, and Pelvic Ring: A Comparison of Data before and after Certification as a DGUMedicina (Kaunas, Lithuania) · 2021Observational
- Care of Geriatric Patients with Lumbar Spine, Pelvic, and Acetabular Fractures before and after Certification as a Geriatric Trauma Center DGUMedicina (Kaunas, Lithuania) · 2021Article
- Hybrid emergency rooms reduce the requirement of blood transfusion in patients with severe trauma.World journal of emergency surgery : WJES · 2021Observational
- Clinical Impact of a Dedicated Trauma Hybrid Operating Room.Journal of the American College of Surgeons · 2021Article
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
backgroundThere is no consensus on reporting nonmortality trauma complications in a graded manner. The Clavien-Dindo scale of complications was originally for elective surgery and requires adaptation to provide meaningful data for trauma patients. In particular, the original score does not account for those treated without surgery. We report an adapted Clavien-Dindo in trauma (ACDiT) scale and apply it to patients managed operatively and nonoperatively.
methodsA combined prospective and retrospective international multicenter observational study was undertaken to apply the ACDiT scale to 484 trauma patients at three university teaching hospitals (Birmingham, England (n = 303); Houston, Texas (n = 113); and Glasgow, Scotland (n = 68)). These included both intensive care unit (ICU) and non-ICU-managed patients. The Clavien-Dindo scoring system was adapted for trauma patients based on consensus amongst an international collaboration of trauma specialists at these sites. Data included whether initial patients were managed operatively or nonoperatively. Complication grades were compared with hospital-free and ICU-free days as other outcome measures of patient morbidity.
resultsTwo hundred seventeen (44.8%) of 484 patients experienced complications, of whom 61 (28.1%) of 217 died (grade V). The remainder consisted of grades I (n = 20), II (n = 60), III (n = 24), and IV (n = 52). There was a strong association between higher ACDiT grade category and lower number of hospital-free and ICU-free days (p < 0.01). Eighty-eight patients with complications did not require surgery, validating the score's usefulness in patients managed nonoperatively.
conclusionThe ACDiT scale can be used to grade the severity of posttrauma complications in patients managed both operatively and nonoperatively. It provides clinically meaningful data for morbidity and mortality meetings and other quality improvement exercises. LEVEL OF EVIDENCE: Prognostic, level IV.
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