Capturing adverse events in elective orthopedic surgery: comparison of administrative, surgeon and reviewer reporting

Can J Surg. 2020 Jan 22;63(1):E35-E37. doi: 10.1503/cjs.019117.


Ensuring adverse event (AE) recording is standardized and accurate is paramount for patient safety. In this discussion, we outline our comparison of AE data collected by orthopedic surgeons and independent clinical reviewers using the Spine Adverse Events Severity System (SAVES) and Orthopedic Surgical Adverse Events Severity System (OrthoSAVES) against AE data recorded by hospital administrative discharge abstract coders. In 164 spine, hip, knee and shoulder patients, reviewers recorded significantly more AEs than coders, and coders recorded significantly more AEs than surgeons. The AEs were recorded similarly by reviewers using SAVES and OrthoSAVES in 48 spine patients. Despite our small sample size and use of different AE tools, we believe it is important to highlight that coders, surgeons and reviewers recorded AEs differently. While further investigations on its utility and cost-effectiveness are necessary, we assert that it is feasible to use Ortho-SAVES to prospectively record AEs across all orthopedic subspecialties.

Publication types

  • Comparative Study

MeSH terms

  • Canada
  • Clinical Coding / statistics & numerical data
  • Elective Surgical Procedures / adverse effects*
  • Elective Surgical Procedures / statistics & numerical data
  • Humans
  • Medical Audit / statistics & numerical data
  • Orthopedic Procedures / adverse effects*
  • Orthopedic Procedures / statistics & numerical data
  • Orthopedic Surgeons / statistics & numerical data
  • Outcome and Process Assessment, Health Care* / statistics & numerical data
  • Patient Discharge / statistics & numerical data