title: Is the classification of intraoperative complications (CLASSIC) related to postoperative course?
abstract: BACKGROUND
  The Classification of Intraoperative Complications (CLASSIC) is one of two recent classification systems for intraoperative adverse events (iAEs), featuring simple but inclusive definitions. No data have been reported regarding the relation between CLASSIC and postoperative course. The aim of the present study was to evaluate the relation between the grade of iAEs and the grade of postoperative complications in patients who underwent hepatopancreaticobiliary (HPB) surgery.
  
  
  METHODS
  Demography, preoperative laboratory parameters, iAEs, postoperative complications, and intraoperative pH and lactate levels of patients who underwent HPB surgery between December 2014 and December 2015 were evaluated retrospectively. The recorded parameters were compared according to the grade of iAEs and the grade of postoperative complications described in the Accordion Severity Classification of Postoperative Complications.
  
  
  RESULTS
  Fifty-eight patients were considered. Mean age was 56 ± 15, 21 female vs. 37 male, 47 malign vs. 11 benign. Demographic features and preoperative status of the patients, and the presence of intraoperative acidosis were not significantly related to the grade of iAEs or postoperative complications. The grade of iAEs was directly proportional to the grade of postoperative complications (p = 0.031). Although it is not statistically significant, lactate level at the end of operation had a potential to predict the postoperative course (p = 0.057).
  
  
  CONCLUSIONS
  The grade of iAEs has a predictive value for the grade of postoperative complications in HPB surgery patients; hence, high grade of iAEs is significantly related to high grade of postoperative complications. Lactate level at the end of operation has the potential to predict the postoperative course.
authors.affiliation: Istanbul Training and Research Hospital, Department of General Surgery, Division of HPB Surgery, Istanbul, 34098, Turkey. Electronic address: erdemkinaci@gmail.com.
authors.forename: Erdem
authors.initials: E
authors.lastname: Kinaci
authors.affiliation: Istanbul Training and Research Hospital, Department of General Surgery, Division of HPB Surgery, Istanbul, 34098, Turkey. Electronic address: mertsevinc34@gmail.com.
authors.forename: Mert Mahsuni
authors.initials: MM
authors.lastname: Sevinc
authors.affiliation: Istanbul Training and Research Hospital, Department of General Surgery, Division of HPB Surgery, Istanbul, 34098, Turkey. Electronic address: savasbayrak74@gmail.com.
authors.forename: Savas
authors.initials: S
authors.lastname: Bayrak
authors.affiliation: Istanbul Training and Research Hospital, Department of General Surgery, Division of HPB Surgery, Istanbul, 34098, Turkey. Electronic address: genelcerrahemreerdogan@gmail.com.
authors.forename: Emre
authors.initials: E
authors.lastname: Erdoğan
authors.affiliation: Istanbul Training and Research Hospital, Department of General Surgery, Division of HPB Surgery, Istanbul, 34098, Turkey. Electronic address: kerimozakay@hotmail.com.
authors.forename: Abdulkerim
authors.initials: A
authors.lastname: Ozakay
authors.affiliation: Istanbul Training and Research Hospital, Department of General Surgery, Division of HPB Surgery, Istanbul, 34098, Turkey. Electronic address: drserkansari@yahoo.com.
authors.forename: Serkan
authors.initials: S
authors.lastname: Sari
mesh_terms: D000328:Adult; D000368:Aged; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000145:classification*; D019344:Lactic Acid / Q000097:blood; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology*; D011184:Postoperative Period; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D019344:Lactic Acid
keywords: Adverse events; Classification; Complications; Intraoperative; Postoperative