title: Utilization of a modified Clavien Classification System in reporting complications after ultrasound-guided percutaneous nephrostomy tube placement: comparison to standard Society of Interventional Radiology practice guidelines.
abstract: OBJECTIVE
  To report our results on percutaneous nephrostomy (PCN) and classify our complications with the Standard of Practice Committee of the Society of Interventional Radiology guidelines and the modified Clavien Classification System (CCS).
  
  
  METHODS
  Three hundred eighty-nine PCN insertions were performed in 322 patients (224 men and 98 women) at our institution. PCN insertion was performed under ultrasound for dilated pelvicalyceal system and ultrasound/fluoroscopy for nondilated system. PCN was considered successful if the catheter was drained urine spontaneously. Number of complications was registered.
  
  
  RESULTS
  Primary successful PCN insertion was achieved in 368 of the 389 procedures (94.6%). The success rates for nondilated and dilated systems were 82.7% and 96.4%, respectively. Major complications occurred in 9.6% and minor complications in 9.9% according to the Society of Interventional Radiology. According to the modified CCS grades I, II, III, IV, and V was 9.9%, 1.2%, 6.8%, 1.2%, and 0.3%, respectively. Age, grade of the hydronephrosis, serum creatinine levels, and mean hemoglobin levels were statistically significant parameters for the occurrence of complications on univariate analysis. The nondilated system has statistically significant parameters affecting the complication rates on multivariate analysis (P = .001, odds ratio [OR] = 6.1, 95% confidence interval [CI] = 2-18.4).
  
  
  CONCLUSIONS
  Percutaneous nephrostomy is a well-known procedure in the treatment of temporary or permanent drainage of an obstructed system. It is very important to define the complications related to interventions for interpretation of clinical comparisons more accurately. Modified CCS is a reproducible system to evaluate the complications.
authors.affiliation: Department of Urology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey. tansudegirmenci@hotmail.com
authors.forename: Tansu
authors.initials: T
authors.lastname: Degirmenci
authors.forename: Bulent
authors.initials: B
authors.lastname: Gunlusoy
authors.forename: Zafer
authors.initials: Z
authors.lastname: Kozacioglu
authors.forename: Murat
authors.initials: M
authors.lastname: Arslan
authors.forename: Yasin
authors.initials: Y
authors.lastname: Ceylan
authors.forename: Bumin
authors.initials: B
authors.lastname: Ors
authors.forename: Suleyman
authors.initials: S
authors.lastname: Minareci
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016001:Confidence Intervals; D004108:Dilatation, Pathologic / Q000150:complications; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects*; D016017:Odds Ratio; D011183:Postoperative Complications / Q000145:classification / Q000209:etiology; D017410:Practice Guidelines as Topic; D015642:Radiology, Interventional; D018084:Ultrasonography, Interventional; D014570:Urologic Diseases / Q000473:pathology / Q000601:surgery*