Evidence map›Paper›PMID 33769003›Full record

SynthesisCanadian journal of surgery. Journal canadien de chirurgie2021

Systematic review of grading systems for adverse surgical outcomes.

Saba Balvardi, Etienne St-Louis, Yasmine Yousef, Asra Toobaie, Elena Guadagno, Robert Baird, Dan Poenaru

Abstract readSystematic Review
In one paragraph

Synthesis in Canadian journal of surgery. Journal canadien de chirurgie, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Prophylactic cholecystectomy offers best outcomes following ERCP clearance of common bile duct stones: a meta-analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023
    Pooled it
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Saba BalvardiFrom the Division of Paediatric General and Thoracic Surgery, McGill University, Montréal, Que. (Balvardi, St-Louis, Yousef, Toobaie, Poenaru); the McConnell Resource Centre, McGill University Health Centre, Montréal, Que. (Guadagno); and the Division of Pediatric General Surgery, University of British Columbia, Vancouver, BC (Baird).
Etienne St-LouisFrom the Division of Paediatric General and Thoracic Surgery, McGill University, Montréal, Que. (Balvardi, St-Louis, Yousef, Toobaie, Poenaru); the McConnell Resource Centre, McGill University Health Centre, Montréal, Que. (Guadagno); and the Division of Pediatric General Surgery, University of British Columbia, Vancouver, BC (Baird).
Yasmine YousefFrom the Division of Paediatric General and Thoracic Surgery, McGill University, Montréal, Que. (Balvardi, St-Louis, Yousef, Toobaie, Poenaru); the McConnell Resource Centre, McGill University Health Centre, Montréal, Que. (Guadagno); and the Division of Pediatric General Surgery, University of British Columbia, Vancouver, BC (Baird).
Asra ToobaieFrom the Division of Paediatric General and Thoracic Surgery, McGill University, Montréal, Que. (Balvardi, St-Louis, Yousef, Toobaie, Poenaru); the McConnell Resource Centre, McGill University Health Centre, Montréal, Que. (Guadagno); and the Division of Pediatric General Surgery, University of British Columbia, Vancouver, BC (Baird).
Elena GuadagnoFrom the Division of Paediatric General and Thoracic Surgery, McGill University, Montréal, Que. (Balvardi, St-Louis, Yousef, Toobaie, Poenaru); the McConnell Resource Centre, McGill University Health Centre, Montréal, Que. (Guadagno); and the Division of Pediatric General Surgery, University of British Columbia, Vancouver, BC (Baird).
Robert BairdFrom the Division of Paediatric General and Thoracic Surgery, McGill University, Montréal, Que. (Balvardi, St-Louis, Yousef, Toobaie, Poenaru); the McConnell Resource Centre, McGill University Health Centre, Montréal, Que. (Guadagno); and the Division of Pediatric General Surgery, University of British Columbia, Vancouver, BC (Baird).
Dan PoenaruFrom the Division of Paediatric General and Thoracic Surgery, McGill University, Montréal, Que. (Balvardi, St-Louis, Yousef, Toobaie, Poenaru); the McConnell Resource Centre, McGill University Health Centre, Montréal, Que. (Guadagno); and the Division of Pediatric General Surgery, University of British Columbia, Vancouver, BC (Baird).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Grading scales for adverse surgical outcomes have been poorly characterized to date. The primary aim of this study was to conduct a systematic review to enumerate the various frameworks for grading adverse postoperative outcomes; our secondary objective was to outline the properties of each grading system, identifying its strengths and weaknesses. Methods: We searched 9 databases (Africa Wide Information, Biosis, Cochrane, Embase, Global Health, LILACs, Medline, PubMed and Web of Science) from 1992 (the year the Clavien-Dindo classification system was developed) until Mar. 2, 2017, for studies that aimed to develop or improve on an already existing generalizable system for grading adverse postoperative outcomes. Study selection was duplicated as per PRISMA recommendations. Procedure-specific grading systems were excluded. We assessed the framework, strengths and weaknesses of the systems qualitatively. Results: We identified 9 studies on 8 adverse outcome grading systems with frameworks generalizable to any surgical procedure. Most systems have not been widely incorporated in the literature. Seven of the 8 systems were produced without including patients' perspectives. Four allowed the derivation of a composite morbidity score, which had limited tangible significance for patients. Conclusion: Although each instrument identified offered its own advantages, none satisfied the need for a patient-centred tool capable of generating a composite score of all possible postoperative adverse outcomes (complications, sequelae and failure) that enables comparison of noninterventional and surgical management of disease. There is a need for development of a more comprehensive, patient-centred grading system for adverse postoperative outcomes.

Indexed as

Severity of Illness IndexHumansPostoperative Complications

Identifiers

PMID33769003
PMCPMC8064246

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.