Complications reporting has widely used the Clavien-Dindo classification (CDC) (Dindo et al 2004, Clavien et al 2009). The CDC requires the single most severe complication during a given episode of care to be reported. This does not account for lesser severe complications nor the number of total complications.

The Comprehensive Complications Index (CCI) was proposed in 2013 to address some of these matters (Slankamenac et al 2013). This scale still contained disadvantages particularly when used in patients undergoing major surgery with potential to develop multiple complications in one admission. Subsequently the modified Berne CCI was developed to better summarize patient burden and to improve ease of use by setting the upper limit to 100 (Furrer et al 2018) as well as accounting for each intervention in complications requiring multiple interventions. ~