Accuracy of application of Bern CCI; Prospective Trial

Survey to prospectively evaluate the Bern Comprehensive Complications Index (Bern CCI) arm of the CAMUS collaboration.

Aim

This is a worldwide, multi-centre survey (see link) to prospectively evaluate applicability, usability and practicality of both the Bern Comprehensive Complications Index (Bern CCI) and the online calculator.

The survey consists of a four-part questionnaire.

The results of this trial should reveal whether the Bern CCI could, in future, be considered as the standardised reporting system for major Urological complications.

Background

The Bern CCI was developed to address some of the disadvantages of existing complications reporting systems. Previously, since 2004, the Clavien-Dindo classification (CDC) system has widely been used as the standard for post-operative complication reporting. The CDC requires the single most severe complication during a given episode of care to be reported, without accounting for less severe complications, nor the number of total complications.

To address this shortcoming the Comprehensive Complications Index (CCI) was proposed in 2013. This index integrates every complication and subsequent required interventions in the 90-day post-operative window and calculates a score between 0 (no complication) – 100 (death). However, this index still contained several pitfalls of its own. Particularly, when applied to patients undergoing major, complex surgeries with the potential to develop multiple complications, the score may exceed the upper limit of 100 (beyond death itself). Subsequently, the Berne CCI was developed. Its particular advantage is, in our opinion, that it prevents overestimation of patients’ burden by distributing smaller values for minor complications, and thus never exceeds the upper limit. This is of upmost importance as firstly, arguably nothing is worse than death and secondly, an index should not exceed a certain threshold for mathematical correctness.

For further information see our published work which is also available on our website (link: XXX)