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 Release 21.0, Jan 2008
 
Chapter : ch31. Anesthesiology Section : Preoperative Patient Classification and Preparation
  Operation Complexity Grades in the Veterans Admnistration (VA)

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Copyright (c) 2006-2007, Institute for Algorithmic Medicine, Houston, TX, USA. All rights reserved.

Overview :

The Veterans Administration (VA) classifies the complexity of a surgical procedure using a scale from 1 to 5. The operative grade correlates with duration of the procedure, cost and complications.

 

Complexity

Example Surgical Procedure

Complexity

minimal

biopsy, debridement, hemorrhoidectomy, simple hernia

1.0 to 1.9

mild

gallbladder, exploratory laparotomy, major breast surgery, soft-tissue surgery

2.0 to 2.9

moderate

major biliary, gastric, colorectal surgery

3.0 to 3.9

signficant

low anastomosis with pouch, esophagectomy

4.0 to 4.9

extreme

Whipple procedure, pelvic extenteration

5.0

 

A number of factors may increase the complexity of a procedure:

(1) emergency or urgency

(2) previous surgery with adhesions

(3) viscus rupture with infection

(4) comorbid conditions

 

  References:

Aust JB, Henderson W, et al. the impact of operative complexity on patient risk factors. Annals Surgery. 2005; 241: 1024-1028 (Table 3, page 1026).

 

 

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