Registration and analysis of complications in the neurosurgical clinic

Abstract

BACKGROUND: Currently, in medicine, including neurosurgery, systemic risk management to improve treatment quality is one of the most urgent tasks. The key indicators of treatment quality in neurosurgery are the characteristics of its outcomes, structure, and number of complications.

OBJECTIVE: To formulate the most concise and complete definition of “complication” and develop a classification scheme that allows the maximum consideration of complications in patients with neurosurgical problems.

MATERIALS AND METHODS: A neurosurgical complication was defined as any unwanted, unintended deviation from the ideal course of the treatment process for a patient with neurosurgical pathology. The study included patients operated on for neurosurgical pathology at the Center for Neurosurgery (Moscow) from January 2019 to December 2020. To record all complications, an electronic database was created, where information about all neurosurgical complications was entered.

RESULTS. Based on the analysis of annual reports of medical and diagnostic departments, the average incidence of complications was 25–29 per 1000 operations (2.5–2.9%). The study of neurosurgical complications made it possible to determine the general parameters that are of key importance for the registration and analysis of neurosurgical complications and formulate an original classification scheme, and its use makes it possible to consider most of the factors associated with complications and, accordingly, their analysis.

CONCLUSION: In the literature analysis, a series of discussions within the neurosurgical community, and our experience, we proposed a definition of «neurosurgical complication» and an approach to registering complications. With the help of the proposed classification scheme, we could obtain objective data and conduct evidence-based analysis, which makes it possible to evaluate complications using a treatment quality control system by obtaining the most complete amount of data on complications in a neurosurgical clinic.

Keywords

neurosurgical complications / classification of complications / classification scheme of complications / adverse events

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