Troëng T, Malmstedt J, Björck M
Department of Surgery, Blekinge Hospital, S-371 85 Karlskrona, Sweden.
Eur J Vasc Endovasc Surg. 2008 Dec;36(6):705-12. doi: 10.1016/j.ejvs.2008.08.017. Epub 2008 Oct 11.
To study external validity of the Swedvasc registry concerning numbers of procedures and mortality.
Vascular registry data for carotid, infrainguinal bypass and aortic aneurysm (AAA) procedures were compared to the Swedish Hospital Discharge Register (SHDR) data, and the National Population Registry (for mortality) by matching every individual patient using the unique personal identity numbers (PINs). The time-period studied was 2000-2004 (5 years) for carotid and infrainguinal procedures. A separate analysis was performed for AAA-surgery in 2006.
The external validity for carotid, infrainguinal bypass and AAA repair was 93.4%, 93.0% and 93.1%, respectively. The 30-day mortality was 0.86% after carotid and 2.9% after infrainguinal bypass procedures. Mortality was 2.6% after planned and 25.9% after unplanned AAA repair. Although there was a general trend towards inferior outcomes after procedures not registered in the Swedvasc, those procedures were so few that in none of the analyses did the inclusion of non-registered procedures affect general outcomes significantly. Combining data from both registries, the incidence for carotid, infrainguinal bypass and AAA procedures was 7.8, 15.2 and 13.6 per 100,000 person-years, respectively. In the hospital-specific analysis for 2006 it was shown that the non-registered procedures for AAA were localized to one non-compliant county hospital, and small district hospitals not performing elective AAA-surgery but only rare emergency operations.
The external and internal validity of the Swedvasc registry allows to confidently assess volumes of, and mortality after, vascular surgery in Sweden.
研究瑞典血管外科注册登记系统（Swedvasc）在手术数量和死亡率方面的外部效度。
通过使用唯一的个人身份号码（PIN）对每位患者进行匹配，将颈动脉、腹股沟下旁路移植术和主动脉瘤（AAA）手术的血管注册登记数据与瑞典医院出院登记系统（SHDR）数据以及国家人口登记系统（用于死亡率）进行比较。研究的时间段为2000 - 2004年（5年），针对颈动脉和腹股沟下手术。对2006年的AAA手术进行了单独分析。
颈动脉手术、腹股沟下旁路移植术和AAA修复术的外部效度分别为93.4%、93.0%和93.1%。颈动脉手术后30天死亡率为0.86%，腹股沟下旁路移植术后为2.9%。计划性AAA修复术后死亡率为2.6%，非计划性AAA修复术后为25.9%。尽管在Swedvasc中未登记的手术后总体结果有较差的趋势，但这些手术数量极少，在任何分析中纳入未登记的手术均未显著影响总体结果。合并两个登记系统的数据，颈动脉、腹股沟下旁路移植术和AAA手术的发病率分别为每10万人年7.8、15.2和13.6例。在2006年的医院特定分析中显示，AAA未登记手术集中在一家不符合要求的县级医院以及不进行择期AAA手术仅进行罕见急诊手术的小型地区医院。
Swedvasc注册登记系统的外部和内部效度使得能够可靠地评估瑞典血管外科手术的数量和术后死亡率。
