Department of Ophthalmology, Glostrup University Hospital, Copenhagen, Denmark.
Acta Ophthalmol. 2013 Dec;91(8):701-8. doi: 10.1111/aos.12279.
To compare the risk of postoperative endophthalmitis (PE) after cataract surgery at eye departments in public hospitals and private hospitals/eye clinics and to evaluate if the Danish National Patient Registry (NPR) is a reliable database to monitor the PE risk.
Postoperative endophthalmitis cases were retrospectively identified via the NPR and chart review in order to confirm PE cases that had cataract surgery in the calendar period 2002-2010.
We identified 39 cases of PE after 107 701 registered public cataract operations; PE risk = 0.36 [corrected] per 1000 operations and 27 cases of PE after 36 760 registered private operations; PE risk = 0.73 [corrected] per 1000 operations. There was homogeneity in the PE risk among the eye departments in public hospitals (p = 0.6), but heterogeneity in the PE risk among the private hospitals/eye clinics (p = 0.0001). Six private hospitals/eye clinics had a statistically significantly higher PE risk compared with the eye departments in public hospitals. In all, 98% of public cataract surgery was registered in the NPR compared with 38% of private cataract surgery. The private hospitals/eye clinics with the highest PE risk after registered cataract surgery had many cases of PE where the causative cataract operation was not registered with the NPR.
A few private hospitals/eye clinics had a statistically significantly higher PE risk than the PE risk at the eye departments in public hospitals. The lack of registration with the NPR by the private hospitals/eye clinics suggests that better monitoring of cataract surgery is needed in Denmark to reduce risk and to improve quality.
比较公立医院和私立医院/眼科诊所眼科白内障手术后眼内炎（PE）的风险，并评估丹麦国家患者登记系统（NPR）是否是监测 PE 风险的可靠数据库。
通过 NPR 和病历回顾，回顾性地确定术后眼内炎病例，以确认在 2002-2010 年期间接受白内障手术的 PE 病例。
我们在 107701 例登记的公立医院白内障手术中发现了 39 例 PE；PE 风险=每 1000 例手术 0.36 [校正]；在 36760 例登记的私立手术中发现了 27 例 PE；PE 风险=每 1000 例手术 0.73 [校正]。公立医院眼科部门的 PE 风险具有同质性（p=0.6），但私立医院/眼科诊所的 PE 风险存在异质性（p=0.0001）。与公立医院眼科部门相比，有 6 家私立医院/眼科诊所的 PE 风险具有统计学意义。在公立医院，98%的白内障手术都在 NPR 中登记，而私立医院只有 38%的白内障手术在 NPR 中登记。在已登记的白内障手术后，PE 风险最高的私立医院/眼科诊所中，许多白内障手术未在 NPR 中登记。
少数私立医院/眼科诊所的 PE 风险明显高于公立医院的 PE 风险。私立医院/眼科诊所未在 NPR 中登记表明丹麦需要更好地监测白内障手术，以降低风险并提高质量。
