title: Usefulness of surgical complexity classification index in cataract surgery process.
abstract: OBJECTIVE
  To evaluate the usefulness of surgical complexity classification index (SCCI) to predict the degree of surgical difficulty in cataract surgery.
  
  
  METHODS
  This retrospective study includes data collected between January 2013 and December 2014 from patients who underwent cataract extraction by phacoemulsification at our hospital. A sample size of 159 patients was obtained by simple random sampling (P=.5, 10% accuracy, 95% confidence). The main variables were: recording and value of SCCI in electronic medical record (EMR), presence of exfoliation syndrome (XFS), criteria for inclusion in surgical waiting list (SWL), and functional results. SCCI was classified into 7 categories (range: 1-4) according to predictors of technical difficulty, which was indirectly estimated in terms of surgical time (ST). All statistical analyses were performed using SPSS v15.0 statistical software.
  
  
  RESULTS
  Prevalence of XFS was 18.2% (95%CI: 11.9-24.5). In terms of quality indicators in the cataract surgery process, 96.8% of patients met at least one of the criteria to be included in SWL, and 98.1% gained ≥2 Snellen lines. The SCCI was recorded in EMR of 98.1% patients, and it was grouped for study into 2 categories: High and low surgical complexity. Statistically significant differences in the distribution of ST were found depending on the assigned SCCI (P<.005) and the presence of XFS (P<.005).
  
  
  CONCLUSIONS
  The SCCI enables to estimate the degree of surgical complexity in terms of ST in cataract surgery, which is especially useful in those areas with high prevalence of XFS, because of the higher theoretical risk of surgical complications.
authors.affiliation: Servicio Oftalmología, Área Gestión Clínica Servicios Médico-Quirúrgicos, Hospital Comarcal Jarrio, Coaña (Asturias), España. Electronic address: raquelsalazarmendez@gmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Salazar Méndez
authors.affiliation: Servicio Oftalmología, Área Gestión Clínica Servicios Médico-Quirúrgicos, Hospital Comarcal Jarrio, Coaña (Asturias), España.
authors.forename: M
authors.initials: M
authors.lastname: Cuesta García
authors.affiliation: Unidad Calidad, Investigación y Salud Pública, Hospital Comarcal Jarrio, Coaña (Asturias), España.
authors.forename: M E
authors.initials: ME
authors.lastname: Llaneza Velasco
authors.affiliation: Servicio Oftalmología, Área Gestión Clínica Servicios Médico-Quirúrgicos, Hospital Comarcal Jarrio, Coaña (Asturias), España.
authors.forename: S
authors.initials: S
authors.lastname: Rodríguez Villa
authors.affiliation: Servicio Oftalmología, Área Gestión Clínica Servicios Médico-Quirúrgicos, Hospital Comarcal Jarrio, Coaña (Asturias), España.
authors.forename: M
authors.initials: M
authors.lastname: Cubillas Martín
authors.affiliation: Asistencia Sanitaria y Salud Pública, Área I SESPA (Servicio de Salud del Principado Asturias), Hospital Comarcal Jarrio, Coaña (Asturias), España.
authors.forename: C M
authors.initials: CM
authors.lastname: Alonso Álvarez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000453:epidemiology; D002387:Cataract Extraction / Q000145:classification* / Q000379:methods; D002391:Catchment Area, Health; D015897:Comorbidity; D003710:Demography; D057286:Electronic Health Records; D017889:Exfoliation Syndrome / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D018579:Patient Selection; D012189:Retrospective Studies; D018401:Sample Size; D012494:Sampling Studies; D012720:Severity of Illness Index; D014850:Waiting Lists; D055815:Young Adult
keywords: Ambulatory surgical procedures; Cataract; Catarata; Exfoliation syndrome; Facoemulsificación; Indicadores de calidad; Phacoemulsification; Procedimientos quirúrgicos ambulatorios; Quality indicators; Surgical time; Síndrome de pseudoexfoliación; Tiempo quirúrgico