Study Protocol for the Intraoperative Complications Assessment and Reporting with Universal Standards (ICARUS) Global Cross-Specialty Surveys Among Surgeons, Anesthesiologists, Nurses, Interventional Cardiologists, and Interventional Radiologists

Every year, approximately 200 million surgeries are performed worldwide, and intraoperative adverse events (iAEs) have a significant impact on patients and surgeons. Despite their importance, the true scale of iAEs remains underestimated due to inadequate methods for assessment, collection, grading, and reporting. Various grading systems have been introduced over the past decade, but their adoption has been limited, leading to inconsistencies in reporting. Furthermore, a lack of standardized frameworks for defining, assessing, and collecting iAEs, coupled with litigation concerns, contributes to underreporting. Only half of surgery and anesthesiology journals provide guidance on reporting perioperative adverse events, and recommendations for reporting iAEs are notably lacking in surgical literature. To address these issues, the Intraoperative Complications Assessment and Reporting with Universal Standard (ICARUS) Global Surgical Collaboration was established in 2022. The initiative involves conducting global surveys and a Delphi consensus to understand the barriers for poor reporting of iAEs, validate shared criteria for reporting, define iAEs according to surgical procedures, evaluate the existing grading systems reliability, and identify strategies for enhancing the collection, reporting, and management of iAEs. A sample size of 2,398 respondents was calculated for the study, with invitations extended to 86,574 healthcare providers. This effort represents an essential step towards improved patient safety and the well-being of healthcare professionals in the surgical field.