Severity of Postoperative Complications From the Perspective of the Patient

• Published in: Journal of patient experience 2020-12, Vol.7 (6), p.1568-1576
• Main Authors: Rendell, Victoria R, Siy, Alexander B, Stafford, Linda M Cherney, Schmocker, Ryan K, Leverson, Glen E, Winslow, Emily R
• Format: Article
• Language: English
• Subjects: Patients
• ISSN: 2374-3735; 2374-3743
• DOI: 10.1177/2374373519893199

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.