scholarly journals O23 SURGICAL REPAIR OF PARASTOMAL BULGING - A REGISTER-BASED STUDY

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Marianne Krogsgaard ◽  
Ismail Gögenur ◽  
Frederik Helgstrand ◽  
Rune Martens Andersen ◽  
Anne Kjærgaard Danielsen ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Laparoscopic Repair ◽  
Cumulative Incidence ◽  
Surgical Repair ◽  
Primary Repair ◽  
Stoma Reversal ◽  
National Patient Register ◽  
National Patient ◽  
Surgical Data ◽  
Danish National Patient Register

Abstract Aim To examine the incidence of primary and recurrent repair and types of repair performed in patients with parastomal bulging. Material and Methods We linked prospectively collected data on parastomal bulging from the Danish Stoma Database to surgical data on repair of parastomal bulging from the Danish National Patient Register. Survival statistics provided cumulative incidences and time until primary and recurrent repair Results Of 1016 patients, registered from 2010-2017 with a permanent stoma and a parastomal bulge, 180 (18%) underwent surgical repair. The cumulative incidence of a primary repair was 9% (95% CI [8%; 11%]) within 1 year and 19% (95% CI [17%; 22%]) within 5 years after the occurrence of a parastomal bulge. For colostomies and ileostomies, we found similar probability of undergoing primary repair. For recurrent repair, the 5-year cumulative incidence was 5% (95% CI [3%; 7%]). The probability of undergoing further recurrent repair was 33% (95% CI [21%; 46%]) within 5 years. For primary repair, open or laparoscopic repair with mesh (43%) and stoma revision (39%) were performed almost equally frequent. Stoma revision and repair with mesh could precede and follow one another as primary and recurrent repair. Stoma reversal was performed in 17% of patients. Conclusions Our data offered a new and comprehensive view of the course of surgical treatment of parastomal bulging. Five years after the occurrence of a parastomal bulge the estimated probability of undergoing a repair was 19%. The probability of undergoing recurrent repair was high and stoma reversal more common than expected.

scholarly journals Accuracy of the hypospadias diagnoses and surgical treatment registrations in the Danish National Patient Register

2017 ◽  
Vol Volume 9 ◽  
pp. 483-489 ◽  
Author(s):  
Linn Håkonsen Arendt ◽  
Andreas Ernst ◽  
Morten Søndergaard Lindhard ◽  
Anne Aggerholm Jønsson ◽  
Tine Brink Henriksen ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
National Patient Register ◽  
Patient Register ◽  
National Patient ◽  
Danish National Patient Register

scholarly journals Lateral Ankle Instability Surgical Treatment

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Bahman Sahranavard ◽  
Cesar de Cesar Netto ◽  
Ashish Shah ◽  
Parke Hudson ◽  
Ibukunoluwa Araoye ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Revision Surgery ◽  
Surgical Repair ◽  
Ankle Instability ◽  
Primary Repair ◽  
P Value ◽  
Complication Rates ◽  
Suture Anchors ◽  
Lateral Ankle ◽  
Lateral Ankle Instability

Category: Ankle, Sports Introduction/Purpose: Lateral ankle instability is a common cause of disability in the active population. Although the majority of patients can be treated conservatively, surgical repair of the ligaments, with or without reinforcement, represents an excellent option for refractory cases. Failed primary surgical repair, recurrence of the ankle instability and need for revision surgery can rarely happen and is probably affected by multiple variables. That includes patient’s characteristics such as BMI and comorbidities and surgical aspects such as the use of suture anchors and soft-tissue reinforcement. The purpose of this study was to compare patient’s characteristics and complication rates of primary repair and revision procedures. Methods: We retrospectively reviewed 231 patients (160 Female, 71 Male) who underwent surgical treatment for lateral ankle instability between 2010-2016. Thirty-two were revision cases (14.2%), including 24 females and 8 males, and 199 were primary direct repairs (85.8%). The mean age at the time of the surgery was 39 (19-65)years, and average follow-up was 9 (2-55) months. The procedures were performed by four different surgeons. All cases were reviewed based on age, gender, BMI, procedure type and number of incisions, comorbidities, and complications. Data found was compared between the two groups (primary repair and revision surgery) by T-test. A p-value <0.05 was considered significant. Results: The Brostrom-Gould procedure was used in 69.5% of the primary repairs and 63.6% of the revision cases. The use of suture anchors was also similar in both groups (51%). Repair of the calcaneofibular ligament was performed in 68% of primary repairs and 81.8% of the revisions. We didn’t find significant differences regarding comorbidities between two groups: smoking (23.4% x 27.2%, p-value 0.371); diabetes (6.8% x 6%, p-value 0.951) and body mass index above 30 (28.5% x 24.2%, p-value 0.347). We found significant difference in the complication rate of the procedures, with a higher incidence in the revision group (48.4%) when compared to the primary repair group (24%). That included: sural neuritis (15.1% x 3.4%), superficial peroneal neuritis (12.1% x 4.5%), skin problems (9% x 7.4%). Conclusion: Our study of 231 patients that underwent surgical treatment for lateral ankle instability found significant higher incidence of complications in patients who had revision procedures when compared to primary repair. No differences regarding smoking status, diabetes and BMI were found.

scholarly journals Pediatric acquired demyelinating syndromes: a nationwide validation study of the Danish National Patient Register

2018 ◽  
Vol Volume 10 ◽  
pp. 391-399 ◽  
Author(s):  
Magnus Spangsberg Boesen ◽  
Melinda Magyari ◽  
Alfred Born ◽  
Lau Caspar Thygesen
Keyword(s):  
Validation Study ◽  
National Patient Register ◽  
Patient Register ◽  
National Patient ◽  
Danish National Patient Register

Predictive value of stroke discharge diagnoses in the Danish National Patient Register

2017 ◽  
Vol 45 (6) ◽  
pp. 630-636 ◽  
Author(s):  
Pernille Lühdorf ◽  
Kim Overvad ◽  
Erik B. Schmidt ◽  
Søren P. Johnsen ◽  
Flemming W. Bach
Keyword(s):  
Predictive Value ◽  
Medical Records ◽  
Outpatient Clinics ◽  
Discharge Diagnosis ◽  
Predictive Values ◽  
National Patient Register ◽  
Patient Register ◽  
Stroke Diagnosis ◽  
National Patient ◽  
Danish National Patient Register

Aims: To determine the positive predictive values for stroke discharge diagnoses, including subarachnoidal haemorrhage, intracerebral haemorrhage and cerebral infarction in the Danish National Patient Register. Methods: Participants in the Danish cohort study Diet, Cancer and Health with a stroke discharge diagnosis in the National Patient Register between 1993 and 2009 were identified and their medical records were retrieved for validation of the diagnoses. Results: A total of 3326 records of possible cases of stroke were reviewed. The overall positive predictive value for stroke was 69.3% (95% confidence interval (CI) 67.8–70.9%). The predictive values differed according to hospital characteristics, with the highest predictive value of 87.8% (95% CI 85.5–90.1%) found in departments of neurology and the lowest predictive value of 43.0% (95% CI 37.6–48.5%) found in outpatient clinics. Conclusions: The overall stroke diagnosis in the Danish National Patient Register had a limited predictive value. We therefore recommend the critical use of non-validated register data for research on stroke. The possibility of optimising the predictive values based on more advanced algorithms should be considered.

Validity of the diagnosis of appendicitis in the Danish National Patient Register

2018 ◽  
Vol 48 (1) ◽  
pp. 38-42 ◽  
Author(s):  
Jakob Kleif ◽  
Lau C. Thygesen ◽  
Ismail Gögenur
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Surgical Removal ◽  
Predictive Values ◽  
National Patient Register ◽  
Patient Register ◽  
National Patient ◽  
Sensitivity Specificity ◽  
Danish National Patient Register

Aims: Appendicitis is a common disease. The nationwide Danish National Patient Register provides an important data source for epidemiological research. Data used in register-based epidemiological research needs to be validated. We aimed to validate the diagnosis of appendicitis in the Danish National Patient Register. Methods: From 1997 to 2015 nationwide data from the Danish National Patient Register, the Danish Pathology Register, and the Danish Civil Registration System were used to validate the diagnosis of appendicitis or the combination of the diagnosis for appendicitis and surgical removal of the appendix in the Danish National Patient Register. Sensitivity, specificity, and positive and negative predictive values were calculated using pathology reports as golden standard. Results: Diagnosis of appendicitis in the Danish National Patient Register had a sensitivity, specificity, positive predictive value, and negative predictive value of 0.928 (95% confidence interval (CI): 0.927; 0.930), 0.995 (95% CI: 0.995; 0.995), 0.769 (95% CI: 0.767; 0.771), and 0.999 (95% CI: 0.999; 0.999). A diagnosis of appendicitis and a procedure code for surgical removal of the appendix had a sensitivity, specificity, positive predictive value, and negative predictive value of 0.886 (95% CI: 0.885; 0.888), 0.998 (95% CI: 0.998; 0.998), 0.895 (95% CI: 0.894; 0.897), and 0.998 (95% CI: 0.998; 0.998). Conclusions: The diagnosis of appendicitis alone or in combination with the registered surgical removal of the appendix in the Danish National Patient Register showed acceptable validity. Whether to use the diagnosis for appendicitis only or in combination with procedure codes for the removal of the appendix depends on whether high sensitivity or high positive predictive values are warranted.

scholarly journals Moving from an era of open Appendectomy to an era of Laparoscopic Appendectomy: A Nationwide Cohort Study of Adult Patients Undergoing Surgery for Appendicitis

2021 ◽  
pp. 145749692199261
Author(s):  
J. Kleif ◽  
L. C. Thygesen ◽  
I. Gögenur
Keyword(s):  
Laparoscopic Surgery ◽  
Laparoscopic Appendectomy ◽  
Open Surgery ◽  
Adult Patients ◽  
Registration System ◽  
Postoperative Stay ◽  
National Patient Register ◽  
Patient Register ◽  
National Patient ◽  
Danish National Patient Register

Background and Aims: During the last decades, laparoscopic surgery has been introduced as an alternative to open surgery. We aimed to examine to what extent laparoscopic surgery has replaced open surgery for appendicitis in an entire nation during the last two decades. Second, we examined the effects of shifting to laparoscopic surgery for appendicitis on different quality indicators such as length of postoperative stay and mortality. We also examined age as a predictor of 30-day mortality. Materials and Methods: During the period 2000 to 2015, all adult patients with appendicitis and surgical removal of the appendix were identified in the Danish National Patient Register. Demographics, type of surgery, time of surgery, and duration of postoperative stay were retrieved form Danish National Patient Register. Vital status was retrieved from the Danish Civil Registration System. Results: A total of 58,093 patients underwent surgery for appendicitis. In 2000, a total of 274 out of 3717 (7.4%) had a laparoscopic appendectomy, and the postoperative stay was 55 (iqr: 35–88) h and 30-day mortality was 0.91%. In 2015, a total of 3995 out of 4296 (93.0%) had a laparoscopic appendectomy, and the postoperative stay was 16 (iqr: 9–56) h and 30-day mortality was 0.40%. Age as a predictor of 30-day postoperative mortality had an area under the curve of 0.93 (95% confidence interval: 0.92; 0.94). Conclusion: In Denmark, the standard surgical procedure for appendicitis has changed from open surgery to laparoscopic surgery during the period 2000–2015. At the same time, duration of postoperative stay and 30-day mortality has decreased.

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