Evaluation of the Open Abdomen Classification System: A Validity and Reliability Analysis
Background Classification of the open abdomen (OA) status is essential for clinical studies on the subject and may help to improve OA therapy. This is a validity and reliability analysis of the OA classification proposed by the World Society of the Abdominal Compartment Syndrome in 2013. Methods Pro...
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| Autor*in: |
Bjarnason, Thordur [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2014 |
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| Anmerkung: |
© Société Internationale de Chirurgie 2014 |
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| Übergeordnetes Werk: |
Enthalten in: World Journal of Surgery - Springer-Verlag, 1996, 38(2014), 12 vom: 18. Sept., Seite 3112-3124 |
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| Übergeordnetes Werk: |
volume:38 ; year:2014 ; number:12 ; day:18 ; month:09 ; pages:3112-3124 |
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| DOI / URN: |
10.1007/s00268-014-2716-7 |
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SPR003445658 |
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| 520 | |a Background Classification of the open abdomen (OA) status is essential for clinical studies on the subject and may help to improve OA therapy. This is a validity and reliability analysis of the OA classification proposed by the World Society of the Abdominal Compartment Syndrome in 2013. Methods Prospective data on 111 consecutive OA patients treated with vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) was used. For validity analysis, OA grades were compared with fascial closure and mortality. For reliability analysis, operative reports were graded by three external raters on two different occasions and the results compared. Instructions for use of the classification were constructed and studied by the external raters beforehand. Results The in-hospital mortality rate was 30 % (33/111). The delayed primary fascial closure rate was 89 % (85/95). Most complex grade (p = 0.033), deteriorating grade (p = 0.045), enteric leak (p = 0.001), and enteroatmospheric fistula (p = 0001) were associated with worse clinical outcomes, while initial grade, grade 1A only, contamination, fixation, and frozen abdomen were not. A floor effect was observed, with 20 % of patients receiving the lowest grade throughout OA period. Inter-rater reliability, expressed as intra-class correlation coefficient (ICC), was 0.77, 0.76, and 0.88 (95 % confidence interval 0.66–0.84, 0.65–0.84, and 0.81–0.92, respectively) and test–retest reliability 1.0, 0.99, and 0.95, respectively. Conclusions More complex OA grades were associated with worse clinical outcomes. However, favorable clinical results with the VAWCM technique caused many patients to receive the lowest grade, thus causing a floor effect and lower validity. Inter-rater and test–retest reliability was ‘good’ to ‘very good’. | ||
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10.1007/s00268-014-2716-7 doi (DE-627)SPR003445658 (SPR)s00268-014-2716-7-e DE-627 ger DE-627 rakwb eng Bjarnason, Thordur verfasserin aut Evaluation of the Open Abdomen Classification System: A Validity and Reliability Analysis 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2014 Background Classification of the open abdomen (OA) status is essential for clinical studies on the subject and may help to improve OA therapy. This is a validity and reliability analysis of the OA classification proposed by the World Society of the Abdominal Compartment Syndrome in 2013. Methods Prospective data on 111 consecutive OA patients treated with vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) was used. For validity analysis, OA grades were compared with fascial closure and mortality. For reliability analysis, operative reports were graded by three external raters on two different occasions and the results compared. Instructions for use of the classification were constructed and studied by the external raters beforehand. Results The in-hospital mortality rate was 30 % (33/111). The delayed primary fascial closure rate was 89 % (85/95). Most complex grade (p = 0.033), deteriorating grade (p = 0.045), enteric leak (p = 0.001), and enteroatmospheric fistula (p = 0001) were associated with worse clinical outcomes, while initial grade, grade 1A only, contamination, fixation, and frozen abdomen were not. A floor effect was observed, with 20 % of patients receiving the lowest grade throughout OA period. Inter-rater reliability, expressed as intra-class correlation coefficient (ICC), was 0.77, 0.76, and 0.88 (95 % confidence interval 0.66–0.84, 0.65–0.84, and 0.81–0.92, respectively) and test–retest reliability 1.0, 0.99, and 0.95, respectively. Conclusions More complex OA grades were associated with worse clinical outcomes. However, favorable clinical results with the VAWCM technique caused many patients to receive the lowest grade, thus causing a floor effect and lower validity. Inter-rater and test–retest reliability was ‘good’ to ‘very good’. Abdominal Compartment Syndrome (dpeaa)DE-He213 Operative Report (dpeaa)DE-He213 Closure Rate (dpeaa)DE-He213 Open Abdomen (dpeaa)DE-He213 Fascial Closure (dpeaa)DE-He213 Montgomery, Agneta aut Acosta, Stefan aut Petersson, Ulf aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 38(2014), 12 vom: 18. Sept., Seite 3112-3124 (DE-627)SPR003391159 nnns volume:38 year:2014 number:12 day:18 month:09 pages:3112-3124 https://dx.doi.org/10.1007/s00268-014-2716-7 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 38 2014 12 18 09 3112-3124 |
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10.1007/s00268-014-2716-7 doi (DE-627)SPR003445658 (SPR)s00268-014-2716-7-e DE-627 ger DE-627 rakwb eng Bjarnason, Thordur verfasserin aut Evaluation of the Open Abdomen Classification System: A Validity and Reliability Analysis 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2014 Background Classification of the open abdomen (OA) status is essential for clinical studies on the subject and may help to improve OA therapy. This is a validity and reliability analysis of the OA classification proposed by the World Society of the Abdominal Compartment Syndrome in 2013. Methods Prospective data on 111 consecutive OA patients treated with vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) was used. For validity analysis, OA grades were compared with fascial closure and mortality. For reliability analysis, operative reports were graded by three external raters on two different occasions and the results compared. Instructions for use of the classification were constructed and studied by the external raters beforehand. Results The in-hospital mortality rate was 30 % (33/111). The delayed primary fascial closure rate was 89 % (85/95). Most complex grade (p = 0.033), deteriorating grade (p = 0.045), enteric leak (p = 0.001), and enteroatmospheric fistula (p = 0001) were associated with worse clinical outcomes, while initial grade, grade 1A only, contamination, fixation, and frozen abdomen were not. A floor effect was observed, with 20 % of patients receiving the lowest grade throughout OA period. Inter-rater reliability, expressed as intra-class correlation coefficient (ICC), was 0.77, 0.76, and 0.88 (95 % confidence interval 0.66–0.84, 0.65–0.84, and 0.81–0.92, respectively) and test–retest reliability 1.0, 0.99, and 0.95, respectively. Conclusions More complex OA grades were associated with worse clinical outcomes. However, favorable clinical results with the VAWCM technique caused many patients to receive the lowest grade, thus causing a floor effect and lower validity. Inter-rater and test–retest reliability was ‘good’ to ‘very good’. Abdominal Compartment Syndrome (dpeaa)DE-He213 Operative Report (dpeaa)DE-He213 Closure Rate (dpeaa)DE-He213 Open Abdomen (dpeaa)DE-He213 Fascial Closure (dpeaa)DE-He213 Montgomery, Agneta aut Acosta, Stefan aut Petersson, Ulf aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 38(2014), 12 vom: 18. Sept., Seite 3112-3124 (DE-627)SPR003391159 nnns volume:38 year:2014 number:12 day:18 month:09 pages:3112-3124 https://dx.doi.org/10.1007/s00268-014-2716-7 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 38 2014 12 18 09 3112-3124 |
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10.1007/s00268-014-2716-7 doi (DE-627)SPR003445658 (SPR)s00268-014-2716-7-e DE-627 ger DE-627 rakwb eng Bjarnason, Thordur verfasserin aut Evaluation of the Open Abdomen Classification System: A Validity and Reliability Analysis 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2014 Background Classification of the open abdomen (OA) status is essential for clinical studies on the subject and may help to improve OA therapy. This is a validity and reliability analysis of the OA classification proposed by the World Society of the Abdominal Compartment Syndrome in 2013. Methods Prospective data on 111 consecutive OA patients treated with vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) was used. For validity analysis, OA grades were compared with fascial closure and mortality. For reliability analysis, operative reports were graded by three external raters on two different occasions and the results compared. Instructions for use of the classification were constructed and studied by the external raters beforehand. Results The in-hospital mortality rate was 30 % (33/111). The delayed primary fascial closure rate was 89 % (85/95). Most complex grade (p = 0.033), deteriorating grade (p = 0.045), enteric leak (p = 0.001), and enteroatmospheric fistula (p = 0001) were associated with worse clinical outcomes, while initial grade, grade 1A only, contamination, fixation, and frozen abdomen were not. A floor effect was observed, with 20 % of patients receiving the lowest grade throughout OA period. Inter-rater reliability, expressed as intra-class correlation coefficient (ICC), was 0.77, 0.76, and 0.88 (95 % confidence interval 0.66–0.84, 0.65–0.84, and 0.81–0.92, respectively) and test–retest reliability 1.0, 0.99, and 0.95, respectively. Conclusions More complex OA grades were associated with worse clinical outcomes. However, favorable clinical results with the VAWCM technique caused many patients to receive the lowest grade, thus causing a floor effect and lower validity. Inter-rater and test–retest reliability was ‘good’ to ‘very good’. Abdominal Compartment Syndrome (dpeaa)DE-He213 Operative Report (dpeaa)DE-He213 Closure Rate (dpeaa)DE-He213 Open Abdomen (dpeaa)DE-He213 Fascial Closure (dpeaa)DE-He213 Montgomery, Agneta aut Acosta, Stefan aut Petersson, Ulf aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 38(2014), 12 vom: 18. Sept., Seite 3112-3124 (DE-627)SPR003391159 nnns volume:38 year:2014 number:12 day:18 month:09 pages:3112-3124 https://dx.doi.org/10.1007/s00268-014-2716-7 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 38 2014 12 18 09 3112-3124 |
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10.1007/s00268-014-2716-7 doi (DE-627)SPR003445658 (SPR)s00268-014-2716-7-e DE-627 ger DE-627 rakwb eng Bjarnason, Thordur verfasserin aut Evaluation of the Open Abdomen Classification System: A Validity and Reliability Analysis 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2014 Background Classification of the open abdomen (OA) status is essential for clinical studies on the subject and may help to improve OA therapy. This is a validity and reliability analysis of the OA classification proposed by the World Society of the Abdominal Compartment Syndrome in 2013. Methods Prospective data on 111 consecutive OA patients treated with vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) was used. For validity analysis, OA grades were compared with fascial closure and mortality. For reliability analysis, operative reports were graded by three external raters on two different occasions and the results compared. Instructions for use of the classification were constructed and studied by the external raters beforehand. Results The in-hospital mortality rate was 30 % (33/111). The delayed primary fascial closure rate was 89 % (85/95). Most complex grade (p = 0.033), deteriorating grade (p = 0.045), enteric leak (p = 0.001), and enteroatmospheric fistula (p = 0001) were associated with worse clinical outcomes, while initial grade, grade 1A only, contamination, fixation, and frozen abdomen were not. A floor effect was observed, with 20 % of patients receiving the lowest grade throughout OA period. Inter-rater reliability, expressed as intra-class correlation coefficient (ICC), was 0.77, 0.76, and 0.88 (95 % confidence interval 0.66–0.84, 0.65–0.84, and 0.81–0.92, respectively) and test–retest reliability 1.0, 0.99, and 0.95, respectively. Conclusions More complex OA grades were associated with worse clinical outcomes. However, favorable clinical results with the VAWCM technique caused many patients to receive the lowest grade, thus causing a floor effect and lower validity. Inter-rater and test–retest reliability was ‘good’ to ‘very good’. Abdominal Compartment Syndrome (dpeaa)DE-He213 Operative Report (dpeaa)DE-He213 Closure Rate (dpeaa)DE-He213 Open Abdomen (dpeaa)DE-He213 Fascial Closure (dpeaa)DE-He213 Montgomery, Agneta aut Acosta, Stefan aut Petersson, Ulf aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 38(2014), 12 vom: 18. Sept., Seite 3112-3124 (DE-627)SPR003391159 nnns volume:38 year:2014 number:12 day:18 month:09 pages:3112-3124 https://dx.doi.org/10.1007/s00268-014-2716-7 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 38 2014 12 18 09 3112-3124 |
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10.1007/s00268-014-2716-7 doi (DE-627)SPR003445658 (SPR)s00268-014-2716-7-e DE-627 ger DE-627 rakwb eng Bjarnason, Thordur verfasserin aut Evaluation of the Open Abdomen Classification System: A Validity and Reliability Analysis 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Société Internationale de Chirurgie 2014 Background Classification of the open abdomen (OA) status is essential for clinical studies on the subject and may help to improve OA therapy. This is a validity and reliability analysis of the OA classification proposed by the World Society of the Abdominal Compartment Syndrome in 2013. Methods Prospective data on 111 consecutive OA patients treated with vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) was used. For validity analysis, OA grades were compared with fascial closure and mortality. For reliability analysis, operative reports were graded by three external raters on two different occasions and the results compared. Instructions for use of the classification were constructed and studied by the external raters beforehand. Results The in-hospital mortality rate was 30 % (33/111). The delayed primary fascial closure rate was 89 % (85/95). Most complex grade (p = 0.033), deteriorating grade (p = 0.045), enteric leak (p = 0.001), and enteroatmospheric fistula (p = 0001) were associated with worse clinical outcomes, while initial grade, grade 1A only, contamination, fixation, and frozen abdomen were not. A floor effect was observed, with 20 % of patients receiving the lowest grade throughout OA period. Inter-rater reliability, expressed as intra-class correlation coefficient (ICC), was 0.77, 0.76, and 0.88 (95 % confidence interval 0.66–0.84, 0.65–0.84, and 0.81–0.92, respectively) and test–retest reliability 1.0, 0.99, and 0.95, respectively. Conclusions More complex OA grades were associated with worse clinical outcomes. However, favorable clinical results with the VAWCM technique caused many patients to receive the lowest grade, thus causing a floor effect and lower validity. Inter-rater and test–retest reliability was ‘good’ to ‘very good’. Abdominal Compartment Syndrome (dpeaa)DE-He213 Operative Report (dpeaa)DE-He213 Closure Rate (dpeaa)DE-He213 Open Abdomen (dpeaa)DE-He213 Fascial Closure (dpeaa)DE-He213 Montgomery, Agneta aut Acosta, Stefan aut Petersson, Ulf aut Enthalten in World Journal of Surgery Springer-Verlag, 1996 38(2014), 12 vom: 18. Sept., Seite 3112-3124 (DE-627)SPR003391159 nnns volume:38 year:2014 number:12 day:18 month:09 pages:3112-3124 https://dx.doi.org/10.1007/s00268-014-2716-7 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 38 2014 12 18 09 3112-3124 |
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This is a validity and reliability analysis of the OA classification proposed by the World Society of the Abdominal Compartment Syndrome in 2013. Methods Prospective data on 111 consecutive OA patients treated with vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) was used. For validity analysis, OA grades were compared with fascial closure and mortality. For reliability analysis, operative reports were graded by three external raters on two different occasions and the results compared. Instructions for use of the classification were constructed and studied by the external raters beforehand. Results The in-hospital mortality rate was 30 % (33/111). The delayed primary fascial closure rate was 89 % (85/95). Most complex grade (p = 0.033), deteriorating grade (p = 0.045), enteric leak (p = 0.001), and enteroatmospheric fistula (p = 0001) were associated with worse clinical outcomes, while initial grade, grade 1A only, contamination, fixation, and frozen abdomen were not. A floor effect was observed, with 20 % of patients receiving the lowest grade throughout OA period. Inter-rater reliability, expressed as intra-class correlation coefficient (ICC), was 0.77, 0.76, and 0.88 (95 % confidence interval 0.66–0.84, 0.65–0.84, and 0.81–0.92, respectively) and test–retest reliability 1.0, 0.99, and 0.95, respectively. Conclusions More complex OA grades were associated with worse clinical outcomes. However, favorable clinical results with the VAWCM technique caused many patients to receive the lowest grade, thus causing a floor effect and lower validity. 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Evaluation of the Open Abdomen Classification System: A Validity and Reliability Analysis |
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Evaluation of the Open Abdomen Classification System: A Validity and Reliability Analysis |
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Bjarnason, Thordur |
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World Journal of Surgery |
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2014 |
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Bjarnason, Thordur Montgomery, Agneta Acosta, Stefan Petersson, Ulf |
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10.1007/s00268-014-2716-7 |
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evaluation of the open abdomen classification system: a validity and reliability analysis |
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Evaluation of the Open Abdomen Classification System: A Validity and Reliability Analysis |
| abstract |
Background Classification of the open abdomen (OA) status is essential for clinical studies on the subject and may help to improve OA therapy. This is a validity and reliability analysis of the OA classification proposed by the World Society of the Abdominal Compartment Syndrome in 2013. Methods Prospective data on 111 consecutive OA patients treated with vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) was used. For validity analysis, OA grades were compared with fascial closure and mortality. For reliability analysis, operative reports were graded by three external raters on two different occasions and the results compared. Instructions for use of the classification were constructed and studied by the external raters beforehand. Results The in-hospital mortality rate was 30 % (33/111). The delayed primary fascial closure rate was 89 % (85/95). Most complex grade (p = 0.033), deteriorating grade (p = 0.045), enteric leak (p = 0.001), and enteroatmospheric fistula (p = 0001) were associated with worse clinical outcomes, while initial grade, grade 1A only, contamination, fixation, and frozen abdomen were not. A floor effect was observed, with 20 % of patients receiving the lowest grade throughout OA period. Inter-rater reliability, expressed as intra-class correlation coefficient (ICC), was 0.77, 0.76, and 0.88 (95 % confidence interval 0.66–0.84, 0.65–0.84, and 0.81–0.92, respectively) and test–retest reliability 1.0, 0.99, and 0.95, respectively. Conclusions More complex OA grades were associated with worse clinical outcomes. However, favorable clinical results with the VAWCM technique caused many patients to receive the lowest grade, thus causing a floor effect and lower validity. Inter-rater and test–retest reliability was ‘good’ to ‘very good’. © Société Internationale de Chirurgie 2014 |
| abstractGer |
Background Classification of the open abdomen (OA) status is essential for clinical studies on the subject and may help to improve OA therapy. This is a validity and reliability analysis of the OA classification proposed by the World Society of the Abdominal Compartment Syndrome in 2013. Methods Prospective data on 111 consecutive OA patients treated with vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) was used. For validity analysis, OA grades were compared with fascial closure and mortality. For reliability analysis, operative reports were graded by three external raters on two different occasions and the results compared. Instructions for use of the classification were constructed and studied by the external raters beforehand. Results The in-hospital mortality rate was 30 % (33/111). The delayed primary fascial closure rate was 89 % (85/95). Most complex grade (p = 0.033), deteriorating grade (p = 0.045), enteric leak (p = 0.001), and enteroatmospheric fistula (p = 0001) were associated with worse clinical outcomes, while initial grade, grade 1A only, contamination, fixation, and frozen abdomen were not. A floor effect was observed, with 20 % of patients receiving the lowest grade throughout OA period. Inter-rater reliability, expressed as intra-class correlation coefficient (ICC), was 0.77, 0.76, and 0.88 (95 % confidence interval 0.66–0.84, 0.65–0.84, and 0.81–0.92, respectively) and test–retest reliability 1.0, 0.99, and 0.95, respectively. Conclusions More complex OA grades were associated with worse clinical outcomes. However, favorable clinical results with the VAWCM technique caused many patients to receive the lowest grade, thus causing a floor effect and lower validity. Inter-rater and test–retest reliability was ‘good’ to ‘very good’. © Société Internationale de Chirurgie 2014 |
| abstract_unstemmed |
Background Classification of the open abdomen (OA) status is essential for clinical studies on the subject and may help to improve OA therapy. This is a validity and reliability analysis of the OA classification proposed by the World Society of the Abdominal Compartment Syndrome in 2013. Methods Prospective data on 111 consecutive OA patients treated with vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) was used. For validity analysis, OA grades were compared with fascial closure and mortality. For reliability analysis, operative reports were graded by three external raters on two different occasions and the results compared. Instructions for use of the classification were constructed and studied by the external raters beforehand. Results The in-hospital mortality rate was 30 % (33/111). The delayed primary fascial closure rate was 89 % (85/95). Most complex grade (p = 0.033), deteriorating grade (p = 0.045), enteric leak (p = 0.001), and enteroatmospheric fistula (p = 0001) were associated with worse clinical outcomes, while initial grade, grade 1A only, contamination, fixation, and frozen abdomen were not. A floor effect was observed, with 20 % of patients receiving the lowest grade throughout OA period. Inter-rater reliability, expressed as intra-class correlation coefficient (ICC), was 0.77, 0.76, and 0.88 (95 % confidence interval 0.66–0.84, 0.65–0.84, and 0.81–0.92, respectively) and test–retest reliability 1.0, 0.99, and 0.95, respectively. Conclusions More complex OA grades were associated with worse clinical outcomes. However, favorable clinical results with the VAWCM technique caused many patients to receive the lowest grade, thus causing a floor effect and lower validity. Inter-rater and test–retest reliability was ‘good’ to ‘very good’. © Société Internationale de Chirurgie 2014 |
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Evaluation of the Open Abdomen Classification System: A Validity and Reliability Analysis |
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Montgomery, Agneta Acosta, Stefan Petersson, Ulf |
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