Spinal Adverse Events Severity System, version 2 (SAVES-V2): inter- and intraobserver reliability assessment

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Surgical Outcomes Research

Background:

• Inconsistent reporting of adverse events (AEs) in spinal surgery hinders study comparability.
• The Spinal Adverse Events Severity System, version 2 (SAVES-V2) was developed to standardize AE classification.
• The reliability of SAVES-V2 for inter- and intraobserver assessment was previously unknown.

Purpose of the Study:

• To evaluate the inter- and intraobserver reliability of the SAVES-V2 grading system.
• To assess the system's consistency in classifying the presence, severity, number, and type of AEs in spinal surgery.
• To determine the agreement on the impact of AEs on length of stay (LOS).

Main Methods:

• Two multinational, multicenter surgical groups (Spine Trauma Study Group and Degenerative Spine Study Group) evaluated case vignettes.
• Participants used SAVES-V2 to assess AEs in trauma (10 cases) and degenerative (12 cases) spinal surgery vignettes.
• Inter- and intraobserver agreement were measured using intraclass correlation (ICC), Cohen's kappa, and percentage agreement over two assessment rounds.

Main Results:

• High agreement (97-100%) was observed for AE presence.
• Substantial agreement was found for AE severity (interobserver ICC=0.75; intraobserver ICC=0.70-0.71).
• Good agreement was noted for AE number and type, with variations in impact on LOS agreement between groups.

Conclusions:

• The SAVES-V2 system shows good inter- and intraobserver agreement for assessing AEs in spinal surgery.
• The system is a simple and reliable tool for identifying and capturing adverse events in both trauma and degenerative spinal procedures.
• Standardization through SAVES-V2 facilitates more consistent and comparable reporting of spinal surgery outcomes.