Classifying complications of interventional procedures: A survey of practicing radiologists

PURPOSE: To determine the variability of radiologists' classification of co mplications from interventional procedures. MATERIALS AND METHODS: Fifteen test cases were selected from a database of morbidity and mortality cases that occurred in our department during the pa st 2 years. Ten cases were selected randomly, and five were chosen because of classification difficulties within our department. A survey with the cas e descriptions was presented to 145 SCVIR members via the World Wide Web an d 48 were distributed to participants at a statewide angiography club meeti ng. Participants were asked to complete a short assessment of the their cli nical background and to classify each case as "no complication," "minor com plication," or "major complication." RESULTS: Thirty-eight percent (74 of 193) of the surveys were completed. Se venty percent (52 of 74) of the respondents were affiliated with an academi c program, 12% (nine of 74) were affiliated with private practice groups, a nd 18% (13 of 74) claimed both academic and private affiliation. The consen sus rate in classifying the complications for the randomly selected cases v aried from 50% to 95%, with a median of 69%, and the consensus rate in clas sifying the selected cases varied from 46% to 95%, with a median of 85%. Th e lowest consensus rates occurred when (i) a significant procedural event w as followed by a normal outcome, (ii) when a procedure was aborted, and (ii i) when a significant event occurred but did not prolong hospital stay. CONCLUSION: Current criteria for reporting complications are associated wit h moderate rates of disagreement among interventional radiologists.