Intraoperative adverse events (IAE) can be classified as any deviation from the ideal intraoperative course between skin incision and skin closure, and includes events related to surgery and anaesthesia.
It is well known that the quality of surgical performance is a major determinant for outcomes. IAEs are associated with an increase in 30-day post-operative mortality, 30-day post-operative morbidity and prolonged post-operative length of stay. Intraoperative complications are often inappropriately combined with postoperative complications or not reported at all.
There is currently an emphasis on improving quality and transparency in healthcare, with that there is a need to develop a simple, systematic, objective, and reproducible grading system for IAEs. It is imperative that the scoring system reflects the surgery undertaken and the impact of the event on the patient and recovery, as not all adverse events are equal. Major events have more significant post-operative morbidity that minor IAE’s.
We have created and validated a scoring system for the classification of intra-operative adverse events which can be applied to the field of gynaecology which can be reproduced with good reliability. It is important the grading system is practical and applicable.