| | | | | | The Medical Algorithms Project |
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| Chapter : | ch31. Anesthesiology | Section : | Preoperative Patient Classification and Preparation | | Operation Complexity Grades in the Veterans Admnistration (VA) | | Copyright (c) 2006-2007, Institute for Algorithmic Medicine, Houston, TX, USA. All rights reserved. |
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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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