Auditing surgical outcome: ten years with the Swedish vascular registry-Swedvasc

Bergqvist, David; Troëng, Thomas; Elfström, Johan; Hedberg, B; Kg, Ljungström; Norgren, Lars; Örtenwall, Per

doi:10.1080/11024159850191607

Cited by 51 publications

(51 citation statements)

References 55 publications

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“…20,21 Several articles have also studied the external and internal validation of Swedvasc showing high accuracy regarding stroke and death within 30 days postoperatively. [22][23][24] We obtained data for patients who underwent intervention for symptomatic carotid stenosis in Sweden between May 12, 2008, and May 31, 2011, and were recorded in Swedvasc (nϭ2763). The study was approved by the regional ethical review board in Gothenburg.…”

Section: Study Populationmentioning

confidence: 99%

Very Urgent Carotid Endarterectomy Confers Increased Procedural Risk

Strömberg

Gélin

Österberg

et al. 2012

Stroke

168

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Background and Purpose— Current Swedish guidelines recommend that carotid endarterectomy should be performed within 14 days of a qualifying neurological event, but it is not clear if very urgent surgery after an event is associated with increased perioperative risk. The aim of this study was to determine how the time between the event and carotid endarterectomy affects the procedural risk of mortality and stroke. Methods— We prospectively analyzed data on all patients who underwent carotid endarterectomies for symptomatic carotid stenosis between May 12, 2008, and May 31, 2011, with records in the Swedish Vascular Registry (Swedvasc). Patients were divided according to time between the qualifying event and surgery (0–2 days, 3–7 days, 8–14 days, 15–180 days). Stroke rate and mortality at 30 days postsurgery were determined. Results— We analyzed data for 2596 patients and found that the combined mortality and stroke rate for patients treated 0 to 2 days after qualifying event was 11.5% (17 of 148) versus 3.6% (29 of 804), 4.0% (27 of 677), and 5.4% (52 of 967) for the groups treated at 3 to 7 days, 8 to 14 days, and 15 to 180 days, respectively. In a multivariate analysis, time was an independent risk factor for perioperative complications: patients treated at 0 to 2 days had a relative OR of 4.24 (CI, 2.07–8.70; P <0.001) compared with the reference 3- to 7-day group. Conclusions— In this study of patients treated for symptomatic carotid disease, it was safe to perform surgery as early as Day 3 after a qualifying neurological event in contrast to patients treated within 0 to 2 days, which has a significantly increased perioperative risk.

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Section: Study Populationmentioning

confidence: 99%

Very Urgent Carotid Endarterectomy Confers Increased Procedural Risk

Strömberg

Gélin

Österberg

et al. 2012

Stroke

168

View full text Add to dashboard Cite

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“…Earlier validation of the Swedvasc database has shown over 90% accuracy of variables (15). We performed further validation with a randomly selected sample of 140 patients (7.6%) from the study cohort.…”

mentioning

confidence: 99%

“…Swedvasc is a population-based, vascular surgery registry covering more than 95% of all arterial vascular procedures performed in the Swedish population (8.5 million) and containing detailed, prospectively registered information on indications, risk factors, and surgical procedures for each individual (15 To study amputation-free survival, we designated our primary outcome as ipsilateral amputation, defined as first amputation above the ankle (i.e., major amputation) in the limb on which bypass was performed (i.e., ipsilateral limb), or death from any cause-whichever occurred first. The observation period began on the index date and continued until the primary outcome event occurred or, if no event occurred, until 31 December 2005.…”

mentioning

confidence: 99%

Outcome After Leg Bypass Surgery for Critical Limb Ischemia Is Poor in Patients With Diabetes

et al. 2008

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OBJECTIVE -Our aim was to assess the risk of major amputation or death after leg bypass surgery for critical limb ischemia in patients with diabetes versus those without. CONCLUSIONS -Diabetes is associated with lower amputation-free survival after leg bypass for critical limb ischemia. Patients with diabetes and limb ischemia need intensified treatment of diabetes-related risk factors to improve outcome. RESEARCH DESIGN AND METHODS

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“…Validity of the registry data is ap rerequisite for any analysis. the accepted level of data can be achieved by revalidation and comparison with the national inpatient registry (8, 15,16). Swedvasc has an automatic linkage on individual patient level to the Population registry (recording death within 3w eeks of every event) and has been givenpermission also to cross-check with the Hospital Discharge registry (17).…”

Section: Data Collectionmentioning

confidence: 99%

The Role of Vascular Registries in Improving the Management of Abdominal Aortic Aneurysm

et al. 2008

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Tr eatment of abdominal aortic aneurysm (aaa) is one of the vascular surgical index procedures and an important part of the total workload. Whichever way treated, it typically has high mortality and morbidity.furthermore, endovascular repair is still arelatively new treatment method and under evolution. Therefore continuous quality control with subsequent outcome analysis, benchmarking, intervention and reassessment are mandatory to achieve high level aneurysm care. va scular registries are tools for this audit. The aim of this review is to focus on the problems and solutions related to attempts to improve the management of abdominal aortic aneurysm with emphasis on the experience gathered in finland. This includes great variations in dynamics over time in southernfinland. To control theinfluence of patient selection andcase-mix, total hospital mortality is emphasized as the most appropriate outcome measure of the level of treatment of ruptured abdominal aortic aneurysm (raaa). To tal aneurysm mortality (including total hospital mortality of raaa and other aaa surgery) is introduced as an outcome measure of vascular service.

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Auditing surgical outcome: ten years with the Swedish vascular registry-Swedvasc

Cited by 51 publications

References 55 publications

Very Urgent Carotid Endarterectomy Confers Increased Procedural Risk

Very Urgent Carotid Endarterectomy Confers Increased Procedural Risk

Outcome After Leg Bypass Surgery for Critical Limb Ischemia Is Poor in Patients With Diabetes

The Role of Vascular Registries in Improving the Management of Abdominal Aortic Aneurysm

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