The Intraoperative Complications Assessment and Reporting with Universal Standards (ICARUS) Global Surgical Collaboration Project: Development of Criteria for Reporting Adverse Events During Surgical Procedures and Evaluating Their Impact on the Postoperative Course

Giovanni E. Cacciamani, Tamir Sholklapper, Paolo Dell'Oglio, Bernardo Rocco, Filippo Annino, Alessandro Antonelli, Michele Amenta, Marco Borghesi, Pierluigi Bove, Giorgio Bozzini, Angelo Cafarelli, Antonio Celia, Costantino Leonardo, Carlo Ceruti, Luca Cindolo, Simone Crivellaro, Orietta Dalpiaz, Roberto Falabella, Mario Falsaperla, Antonio GalfanoFarizio Gallo, Francesco Greco, Andrea Minervini, Paolo Parma, Maria Chiara Sighinolfi, Antonio L. Pastore, Giovannalberto Pini, Angelo Porreca, Luigi Pucci, Carmine Sciorio, Riccardo Schiavina, Paolo Umari, Virginia Varca, Domenico Veneziano, Paolo Verze, Alessandro Volpe, Stefano Zaramella, Amir Lebastchi, Andre Abreu, Dionysios Mitropoulos, Chandra Shekhar Biyani, Rene Sotelo, Mihir Desai, Walter Artibani, Inderbir Gill, ICARUS Global Surgical Collaboration Working Group, F.R. Halfwerk

Research output: Contribution to journalArticleAcademicpeer-review

26 Citations (Scopus)
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Abstract

Background: Intraoperative adverse events (iAEs) are surgical and anesthesiologic complications. Despite the availability of grading criteria, iAEs are infrequently reported in the surgical literature and in cases for which iAEs are reported, these events are described with significant heterogeneity.

Objective: To develop Intraoperative Complications Assessment and Reporting with Universal Standards (ICARUS) Global Surgical Collaboration criteria to standardize the assessment, reporting, and grading of iAEs. The ultimate aim is to improve our understanding of the nature and frequency of iAEs and our ability to counsel patients regarding surgical procedures.

Design, setting, and participants: The present study involved the following steps: (1) collecting criteria for assessing, reporting, and grading of iAEs via a comprehensive umbrella review; (2) collecting additional criteria via a survey of a panel of experienced surgeons (first round of a modified Delphi survey); (3) creating a comprehensive list of reporting criteria; (4) combining criteria acquired in the first two steps; and (5) establishing a consensus on clinical and quality assessment utility as determined in the second round of the Delphi survey.

Outcome measurements and statistical analysis: Panel inter-rater agreement and consistency were assessed as the overall percentage agreement and Cronbach's α.

Results and limitations: The umbrella review led to nine common criteria for assessing, grading, and reporting iAEs, and review of iAE grading systems led to two additional criteria. In the first Delphi round, 35 surgeons responded and two criteria were added. In the second Delphi round, 13 common criteria met the threshold for final guideline inclusion. All 13 criteria achieved the consensus minimum of 70%, with agreement on the usefulness of the criteria for clinical and quality improvement ranging from 74% to 100%. The mean inter-rater agreement was 89.0% for clinical improvement and 88.6% for quality improvement.

Conclusions: The ICARUS Global Collaboration criteria might aid in identifying important criteria when reporting iAEs, which will support all those involved in patient care and scientific publishing.

Patient summary: We consulted a panel of experienced surgeons to develop a set of guidelines for academic surgeons to follow when publishing surgical studies. The surgeon panel proposed a list of 13 criteria that may improve global understanding of complications during specific procedures and thus improve the ability to counsel patients on surgical risk.

Original languageEnglish
Pages (from-to)1847-1858
JournalEuropean urology focus
Volume8
Issue number6
DOIs
Publication statusPublished - Nov 2022

Keywords

  • 2023 OA procedure

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