Langenbeck's Archives of Surgery

, Volume 403, Issue 8, pp 1029–1030 | Cite as

Editorial comment: different perspectives on severity of postoperative morbidity

  • Roxane D. Staiger
  • Milo A. Puhan
  • Pierre-Alain ClavienEmail author

Decreasing postoperative complications remains a challenging objective for all surgeons. To do so, there is the need for adequate recording of all postoperative events, and a grading system by severity. The Clavien-Dindo scale of complications [1] has gained wide acceptance among the surgical community. More recently, a novel metric for morbidity, the Comprehensive Complication Index (CCI®) [2], has been developed and further validated (with values from 0 = no complication to 100 = death) [3, 4] to measure the entire postoperative morbidity from the day of surgery until the majority of all complications are expected to have occured (e.g., 3 months after liver surgery [5]) or beyond. The strong correlation of the CCI® with total cost reflects the comprehensive nature of the CCI® [6].

In their article, Panwar et al. [7] argue that the CCI® gives “inappropriately high scores” to patients with multiple lower grade complications, compared to one single complication with a higher...


Comprehensive Complication Index Complication Severity Score CCI Postoperative complications Morbidity 


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Surgery and TransplantationUniversity Hospital ZurichZurichSwitzerland
  2. 2.Epidemiology, Biostatistics and Prevention InstituteUniversity of ZurichZurichSwitzerland

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