Dindo-Clavien classification of surgical complications

Grade	Definition
Grade I	Any deviation from the normal postoperative course without the need for pharmacologic treatment or surgical, endoscopic, and radiological interventions. Allowed therapeutic regimens are drugs as antiemetics, antipyretics, analgetics, diuretics, electrolytes, and physiotherapy. This grade also includes wound infections opened at the bedside.
Grade II	Requiring pharmacologic treatment with drugs other than such allowed for grade I complications. Blood transfusions and total parenteral nutrition are also included.
Grade IIIa	Requiring surgical, endoscopic, or radiological intervention not under general anesthesia.
Grade IIIb	Requiring surgical, endoscopic, or radiological intervention under general anesthesia.
Grade IVa	Life-threatening complication (including CNS complications)* requiring IC/ICU management, single organ dysfunction (including dialysis).
Grade IVb	Life-threatening complication (including CNS complications)* requiring IC/ICU management, multiorgan dysfunction.
Grade V	Death.

CNS: central nervous system; IC: intermediate care; ICU: intensive care unit.
* Brain hemorrhage, ischemic stroke, subarachnoidal bleeding, but excluding transient ischemic attacks.

Adapted from: Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004; 240:205. Copyright © 2004 American Surgical Association and European Surgical Association. Reproduced with permission from Wolters Kluwer Health. Unauthorized reproduction of this material is prohibited.

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Dindo-Clavien classification of surgical complications