{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T08:18:32Z","timestamp":1783153112723,"version":"3.54.6"},"reference-count":18,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Upper limb orthopedic surgery has no standardized complication classification system. The adaptations in the Clavien-Dindo classification system have only been validated through the creation of scenarios. We hypothesized that the modified Clavien-Dindo-Sink (CDS) classification of hand and upper extremity surgery complications has good intraobserver and interobserver reliability in real-world scenarios. This study assessed the accuracy of the modified CDS classification in real-world scenarios and the absolute incidence of 30-day complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The sample size calculation was based on the modified CDS classification. A kappa value of 0.84, accompanied by a 95% confidence interval (CI) of 0.1 and involving 6 observers, indicated the inclusion of 111 events. To achieve the anticipated sample size of 111 complications, 1850 postoperative procedures will be necessary, given the expected 6% incidence of complications. Six evaluators, each with varying levels of expertise in the field, classified the cases according to the modified CDS classification in 2 rounds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The incidence of early complications was 7.05% (95% CI = 6%-8%) in a tertiary care university hospital. Intraobserver agreement was moderate to almost perfect; however, interobserver agreement was moderate. The less experienced surgeons presented a better interobserver correlation than the more experienced ones.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In a real-world scenario of early postoperative complications of upper extremity surgery, the modified CDS classification presented a lower interobserver correlation than reported in the literature. The surgeon\u2019s experience could influence its applicability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15589447251352121","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T13:38:15Z","timestamp":1753364295000},"page":"1190-1196","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence of Early Postoperative Complications in Upper Extremity Orthopedic Surgery and Reliability of the Modified Clavien-Dindo-Sink Classification: A Real-World Study"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2703-8554","authenticated-orcid":false,"given":"Surya V.","family":"Kohan Fortuna Figueira","sequence":"first","affiliation":[{"name":"Hospital Italiano de Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1224-3312","authenticated-orcid":false,"given":"Fernando","family":"Holc","sequence":"additional","affiliation":[{"name":"Hospital Italiano de Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7790-6092","authenticated-orcid":false,"given":"Pilar","family":"Saralegui","sequence":"additional","affiliation":[{"name":"Hospital Italiano de Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0131-3124","authenticated-orcid":false,"given":"Pedro","family":"Bronenberg Victorica","sequence":"additional","affiliation":[{"name":"Hospital Italiano de Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iv\u00e1n","family":"Huespe","sequence":"additional","affiliation":[{"name":"Hospital Italiano de Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7701-3852","authenticated-orcid":false,"given":"Jorge G.","family":"Boretto","sequence":"additional","affiliation":[{"name":"Hospital Italiano de Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-012-2343-2"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.31053\/1853.0605.v77.n3.27931"},{"issue":"4","key":"e_1_3_3_4_2","article-title":"Reliability of the modified Clavien-Dindo-Sink complication classification system in pediatric orthopaedic surgery","volume":"3","author":"Dodwell ER","year":"2018","unstructured":"Dodwell ER, Pathy R, Widmann RF, et al. Reliability of the modified Clavien-Dindo-Sink complication classification system in pediatric orthopaedic surgery. 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