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Item Development and Validation of a Multidomain Surgical Complication Classification System for Adult Spinal Deformity(LIPPINCOTT WILLIAMS \& WILKINS, 2021-01-01) Klineberg, Eric O.; Wick, Joseph B.; Lafage, Renaud; Lafage, Virginie; Pellise, Ferran; Haddad, Sleiman; Yilgor, Caglar; Nunez-Pereira, Susana; Gupta, Munish; Smith, Justin S.; Shaffrey, Christopher; Schwab, Frank; Ames, Christopher; Bess, Shay; Lewis, Stephen; Lenke, Lawrence G.; Berven, Sigurd; Grp, Int Spine StudyStudy Design. Prospective analysis of example cases Objective. The aim of this study was to analyze the accuracy and repeatability of a new comprehensive classification system for capturing complications data in adult spinal deformity. Summary of Background Data. Complications are common in adult spinal deformity surgery. However, no consensus exists on the definition or classification of complications in adult spinal deformity surgery. The lack of consensus significantly limits understanding of complications' effects on outcomes in surgery for adult spinal deformity. Methods. Using a Delphi method, members of the International Spine Study Group, AO Spine, and the European Spine Study Group collaborated to develop an adult spinal deformity classification system. The multidomain classification system accounts for medical complications (cancer, cardiopulmonary, central nervous system, gastrointestinal, infectious, musculoskeletal, renal) and surgical complications (implant complications, radiographic complications, neurologic events, intraoperative events, and wound complications). Seventeen individuals ({''}event readers{''}), including spine surgeons, trainees, and research coordinators, used the new classification system two separate times to analyze complications in ten example cases. The accuracy and repeatability of the classification system were subsequently calculated based on the providers' responses for the example cases. Results. The 10 example cases included 22 complications. Nearly 95\% of complications were captured by >95\% of the event readers. The system demonstrated good repeatability of 86.9\% between the first and second set of responses provided by event readers. Conclusion. The ISSG-AO Multi-Domain Spinal Deformity Complication Classification System for Adult Spinal Deformity demonstrated good accuracy and repeatability among both surgeons and research coordinators in capturing complications in adult spinal deformity surgery. The ISSG-AO system may be applied to help better understand the impact of complications on outcomes and costs in adult spinal deformity surgery.Item Management of Complications in 1452 Pediatric and Adult Cochlear Implantations(GALENOS YAYINCILIK, 2020-01-01) Dagkiran, Muhammed; Tarkan, Ozgur; Surmelioglu, Ozgur; Ozdemir, Suleyman; Onan, Elvan; Tuncer, Ulku; Bayraktar, Sumbul; Kiroglu, MeteObjective: The aim of this study was to determine the short- and long-term complications after cochlear implantation (CI) procedures and to discuss the management and prevention of these complications. Methods: The study included a total of 1452 pediatric and adult cochlear implantation procedures performed in our clinic from March 2000 through September 2019. Of the 1452 implantations, 1201 were performed in children and 156 in adults. The minimum follow-up period was three months and maximum was 19 years. The mean age of the patients was 6.7 +/- 3.9 years (range, 10 months-69 years) at the time of their respective procedures. Complications were classified as major complications requiring reimplantation, major complications not requiring reimplantation and minor complications. All postoperative complications and treatment methods were examined. Results: A total of 148 (10.1\%) complications were observed in the 1452 cochlear implants. Of these, 69 (4.75\%) were major and 79 (5.44\%) were minor complications. While 40 (2.75\%) of the major complications required reimplantation, 29 (1.99\%) did not. The most common cause of major complications leading to reimplantation was device failure (29 patients, 1.99\%). The most common cause of minor complications was hematoma (21 patients). Total complication rates (6.68\%) were significantly higher in children than in adults (3.51\%) (p=0.00). Conclusion: Our 19 years of clinical experience has shown that CI is a successful and safe procedure that can be performed with low major complication rates. It is important to know the possible complications and to manage them correctly.