1370 Classifying Morbidity and Error in Oral and Maxillofacial Trauma Using the Clavien-Dindo Classification: A Prospective Pilot Study

Abstract

Abstract Introduction The collection of morbidity outcomes following surgery was recommended by the Royal College of Surgeons of England in 2014. They suggest a structure to stratify complications into groupings but do not include a classification this limits comparison. Our unit, a regionalised maxillofacial trauma service, introduced a standardised morbidity and error classification to be applied at M&M meetings. Method Prospective collection of data from March 2019 to February 2020. All patients discussed at our M&M meeting were then classified according to the Clavien-Dindo Classification (2004), assigned an error type and recommended action determined through a panel of between 5-10 consultants. Results 301 surgical procedures were carried out with a 7% complication rate. 26 cases were discussed at M&M. The commonest error type was ‘nature of the disease’ (48%) followed by ‘error in judgement’ (37%). Clavien-Dindo Classification IIIb (intervention under GA) was the most frequent morbidity (74%) Conclusions Standardised national data collection of morbidity and error can be used to analyse a single institution or between institutions to improve patient care. To our knowledge, this is the first standardised classification of morbidity in maxillofacial trauma and was of educational and service benefit. However, there was discussion of the appropriateness of the classification systems to facial fractures. We would therefore recommend further development of both a morbidity classification and an error type classification specific to treatment of facial fractures so that it can be used to improve outcomes for our patients in the future.