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

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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The Danish National Patient Register

Surgery for Obesity and Related Diseases ◽

10.1016/j.soard.2015.11.001 ◽

2016 ◽

Vol 12 (2) ◽

pp. 304

Author(s):

Donald T Hess

Keyword(s):

National Patient Register ◽

Patient Register ◽

National Patient ◽

Danish National Patient Register

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

Clinical Epidemiology ◽

10.2147/clep.s156997 ◽

2018 ◽

Vol Volume 10 ◽

pp. 391-399 ◽

Cited By ~ 11

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

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

Scandinavian Journal of Public Health ◽

10.1177/1403494817716582 ◽

2017 ◽

Vol 45 (6) ◽

pp. 630-636 ◽

Cited By ~ 29

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.

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

Scandinavian Journal of Public Health ◽

10.1177/1403494818761765 ◽

2018 ◽

Vol 48 (1) ◽

pp. 38-42 ◽

Cited By ~ 5

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.

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