Table 1 Accordion Classification System with Severity Weights
Grade Description
1
2
3
4
5
6
Treatment of complication requires only minor invasive procedures that can be done at the bedside, such as
insertion of intravenous lines, urinary catheters, and nasogastric tubes, and drainage of wound infections.
Physiotherapy and antiemetics, antipyretics, analgesics, diuretics, electrolytes, and physiotherapy are permitted.
Complication requires pharmacologic treatment with drugs other than such allowed for minor complications,
e.g. antibiotics. Blood transfusions and total parenteral nutrition are also included.
No general anesthesia is required to treat the complication: requires management by an endoscopic,
interventional procedure, or reoperation without general anesthesia.
General anesthesia is required to treat complication. Alternately, single-organ failure has developed.
General anesthesia is required to treat complication and single organ failure has developed. Alternately,
multisystem organ failure (2 or more organ systems) has developed.
Postoperative death occurred.
Severity
weight
0.110
0.260
0.370
0.600
0.790
1.000
Table 2 Complications classified by Unweighted Severity Grades
PROCEDURE
0*
Inflatable Penile Prosthesis
Nephroureterectomy
Partial Nephrectomy
Percutaneous Nephrostomy tube
Radical Cystectomy
Radical Prostatectomy
ESWL
Transurethral Destruction of Bladder Lesion
Transurethral Prostatectomy
Transurethral Removal of Ureteral Obstruction
Ureteral Catheterization
Subtotal by grade
Subtotal by grade (%)
* "0" means no complications
13
42
8
31
3
101
33
32
56
120
67
506
1
2
2
1
3
10
2
2
15
24
8
69
47%
2
1
9
3
1
3
5
5
3
3
33
22%
Severity Grade
3
4
2
1
4
2
1
1
1
1
5
3%
n
5
6
1
2
1
1
4
10
12
1
38
26%
3
2%
1
0
0%
18
59
13
33
13
118
36
39
87
159
79
654
Table 3 Complications classified by Weighted Severity Grades
PROCEDURE
Inflatable Penile Prosthesis
Nephroureterectomy
Partial Nephrectomy
Percutaneous Nephrostomy tube
Radical Cystectomy
Radical Prostatectomy
ESWL
Transurethral Destruction of Bladder Lesion
Transurethral Prostatectomy
Transurethral Removal of Ureteral Obstruction
Ureteral Catheterization
Subtotal by grade
Subtotal by grade (%)
1
0.22
0.22
0.11
0.33
1.1
0.22
0.22
1.65
2.64
0.88
7.59
18%
2
0.26
2.34
0.78
0.26
0.78
1.3
1.3
0.78
0.78
8.58
20%
Severity Grade
3
4
1.2
0.37
2.4
1.2
0.37
0.37
0.37
0.37
1.85
4%
5
6
0.79
1.2
0.6
0.6
2.4
6
7.2
0.79
22.8
53%
2.37
5%
0.79
0
0%
Total
1.68
6.12
1.98
0.37
3.47
3.37
0.82
3.41
9.32
10.62
2.03
43.19
Table 4 Postoperative morbidity index (PMI), complication rate and severity of complication by procedure
Procedure
Percutaneous Nephrostomy tube
ESWL
Ureteral Catheterization
Radical Prostatectomy
Transurethral Removal of Ureteral Obstruction
Transurethral Destruction of Bladder Lesion
Inflatable Penile Prosthesis
Nephroureterectomy
Transurethral Prostatectomy
Partial Nephrectomy
Radical Cystectomy
*Severity points per Case w here 0 = no complication and 1 = death
** Severity points per case w ith complication
Complication
Rate (% )
6.06
8.33
15.19
14.41
24.53
17.95
27.78
28.81
35.63
38.46
76.92
PMI*
0.011
0.023
0.026
0.029
0.067
0.087
0.093
0.104
0.107
0.152
0.267
Severity of
Complication**
0.185
0.273
0.169
0.198
0.272
0.487
0.336
0.360
0.301
0.396
0.347