Department of Clinical Medicine

Definitions of postoperative complications can save lives

What is a complication after surgery? There is a great variety of what is defined as a complication within perioperative medicine. It makes it difficult to compare studies when endpoints in clinical trials are defined differently.

concerned doctor with patient at hospital looking at journal.
Concerned doctor.

Main content

Almost all types of surgery may lead to complications, either from the procedure itself or in connection with other treatment necessary after surgery - called perioperative treatment. Complications after surgery are known as postoperative complications, and can have a major impact on the patient.

Lack of common standards

Strangely enough, common definitions of what to call postoperative complications and how these complications should be standardized, have not been made either nationally or internationally. This is for example illustrated in an overview article from Cochrane on fluid treatment in surgery, where the authors find that among 31 studies included, not even two used the same definition for complication after surgery.

When investigating complications after surgery, it is crucial that all agree on what should be defined as a complication and which complications that are to be registered. Otherwise comparing studies will prove difficult.

Definitions of postoperative complications

A group from the European Society of Anaesthesiology and the European Society of Intensive Care Medicine has now defined postoperative complications and set a standard for registration of such complications. This is published in an article in which Ib Jammer of the Department of Clinical Medicine and Haukeland University Hospital is  first author, in the last edition of The European Journal of Anaesthesiology.

May save lives

In excess of 230 million patients undergo surgery worldwide each year with reported hospital mortality rates of between 1 and 4%. In addition are complications and injuries that may occur after surgery.

Reference standards to evaluate complications will help investigators to improve the design of clinical trials. Such improvements in perioperative medicine will be of great significance for the lives and quality of life for patients who undergo surgery.