Neurosurgical complications based on modified Clavien-Dindo grade and its correlation with modified Rankin scale: a prospective cohort study from Nepal

Background: The Clavien-Dindo classification (CDC) is a standardized system for classifying surgical complications. The severity of a complication is graded based on the type of therapy required to treat the complication. The assessment of surgical complications is an important tool in neurosurgical practice because it can improve the safety and quality of patient treatment. Among various outcome scales for patient functional performance, the modified Rankin scale (mRS) is a widely accepted outcome scale. Methods: A prospective cohort study was conducted over a 12-month period. Postoperative complications were graded according to the Modified Clavien-Dindo (MCD) grading. Daily evaluation of the patient was conducted during their hospital stay, and they were followed up until postoperative day 30. The outcome was graded as per the mRS. The correlation between MCD grade and the mRS was analyzed. Statistical analysis was performed with SPSS version 25. Results: The study included a total of 180 patients. The maximum number of patients was from 41 to 60 year age group, with 103 (57.2%) being male. A total of 82% of surgeries were cranial, and 62% of patients underwent elective surgery. The mean hospital length of stay was 8.78 days (SD ± 5.2). Overall, 44% of the patients had postoperative complications with a mortality rate of 4.4%. The patients with a higher grade of MCD had a bad outcome, as measured by mRS, with a statistically significant P -value (<0.05). Conclusion: The severity of the post-operative complications, graded as per MCDG, correlated with patient outcomes measured according to the mRS.