Comparison of the Clavien-Dindo Classification and the Comprehensive Complication Index in Assessing Postoperative Complications in Gastrointestinal Malignancies

Surgical complications are graded using various systems, with the Clavien-Dindo classification (CDC) being the most widely used due to its simplicity and ease of replication. The Comprehensive Complication Index (CCI) was recently introduced to overcome the shortcomings of the CDC. This study aims to compare the Clavien-Dindo classification and the Comprehensive Complication Index in assessing post-operative complications. After elective surgery for Gastrointestinal malignancies, post-operative complications were recorded using the CDC and CCI scoring systems. CCI was calculated from free online software (https://www.cci-calculator.com). Using Pearson and Spearman correlations, both scores were correlated with the ICU stay and hospital stay. Between August 2021 and April 2023, 141 patients were included. The median number of complications per patient was 3 (range 1 to 10). The median CCI score was 39.3 (12.2 to 100). The median postoperative hospital stay was 8 days (range, 4-54 days). The median length of ICU stay was 1 day (range, 0-22 days). Using the Pearson and Spearman correlations, there was a strong correlation between both the CDC and CCI with the duration of hospital stay (correlation coefficient, 0.706 vs. 0.731, p < 0.001) and ICU stay (0.768 vs. 0.755, p < 0.001). The Comprehensive Complication Index and the Clavien-Dindo classification highly correlate with the length of hospital stay and ICU stay, with the CCI score having an edge in correlating better with hospital stay. Due to its dynamicity, the CCI score may be a better tool to depict postoperative complications in morbidity meetings and publishing literature.