title: Standardized Grading of Shock Wave Lithotripsy Complications with Modified Clavien System.
abstract: BACKGROUND
  Definitive consensus on grading of complications of shock wave lithotripsy (SWL) does not exist. The objective of this study was to grade complications of SWL in relation to different stone and shock wave parameters, according to the modified Clavien system.
  
  
  METHODS
  Complications observed in 2,648 patients who underwent SWL between January 2003 and May 2014 were evaluated statistically and stratified into 5 grades by the modified Clavien system focusing on stone and shock wave parameters.
  
  
  RESULTS
  Statistically significant association (p ≤ 0.05) was found between SWL outcome, Clavien grade of complications and stone and shock wave parameters. According to the modified Clavien system, grades I, II, IIIa, IIIb, IV and V complications were observed in 1,811 (68.39%), 619 (23.37%), 183 (6.91%), 34 (1.28%), nil (0.00%) and 1 (0.03%) patients, respectively. The overall success rate at 3 months was 87.72%.
  
  
  CONCLUSIONS
  The modified Clavien system provides a standardized grading of SWL complications and can be used to standardize procedural errors and maintain quality, thereby preventing associated complications and improving the overall management and hence outcome of SWL.
authors: Department of Kidney Transplant and Urology, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, India.
authors: Varun
authors: V
authors: Mittal
authors: Anesh
authors: A
authors: Srivastava
authors: Rakesh
authors: R
authors: Kappor
authors: M S
authors: MS
authors: Ansari
authors: Nitesh
authors: N
authors: Patidar
authors: Sohrab
authors: S
authors: Arora
authors: Manoj
authors: M
authors: Kumar
authors: Sharmad
authors: S
authors: Kudchadkar
authors: Anubhav
authors: A
authors: Raj
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014514:Ureteral Calculi / Q000628:therapy*; D055815:Young Adult