Severity of Postoperative Complications From the Perspective of the Patient

Victoria R Rendell; Alexander B Siy; Linda M Cherney Stafford; Ryan K Schmocker; Glen E Leverson; Emily R Winslow

doi:10.1177/2374373519893199

Severity of Postoperative Complications From the Perspective of the Patient

J Patient Exp. 2020 Dec;7(6):1568-1576. doi: 10.1177/2374373519893199. Epub 2019 Dec 26.

Authors

Victoria R Rendell¹, Alexander B Siy¹, Linda M Cherney Stafford¹, Ryan K Schmocker¹, Glen E Leverson¹, Emily R Winslow¹

Affiliation

¹ Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. Schmocker is now with the Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA. Winslow is now with the Medstar Georgetown Transplant Institute, Washington, DC, USA.

Abstract

Background: Although provider-derived surgical complication severity grading systems exist, little is known about the patient perspective.

Objective: To assess patient-rated complication severity and determine concordance with existing grading systems.

Methods: A survey asked general surgery patients to rate the severity of 21 hypothetical postoperative events representing grades 1 to 5 complications from the Accordion Severity Grading System. Concordance with the Accordion scale was examined. Separately, descriptive ratings of 18 brief postoperative events were ranked.

Results: One hundred sixty-eight patients returned a mailed survey following their discharge from a general surgery service. Patients rated grade 4 complications highest. Grade 1 complications were rated similarly to grade 5 and higher than grades 2 and 3 (P ≤ .01). Patients rated one event not considered an Accordion scale complication higher than all but grade 4 complications (P < .001). The brief events also did not follow the Accordion scale, other than the grade 6 complication ranking highest.

Conclusion: Patient-rated complication severity is discordant with provider-derived grading systems, suggesting the need to explore important differences between patient and provider perspectives.

Keywords: communication; patient expectations; patient perspectives/narratives; quantitative methods; survey data.