Vikholm Per, Ivert Torbjörn, Nilsson Johan, Holmgren Anders, Freter Wolfgang, Ternström Lisa, Ghaidan Haider, Sartipy Ulrik, Olsson Christian, Granfeldt Hans, Ragnarsson Sigurdur, Friberg Örjan
Department of Cardiothoracic Surgery, Uppsala University Hospital, Uppsala, Sweden.
Department of Molecular Medicine and Surgery, Karolinska Institutet and Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden.
Interact Cardiovasc Thorac Surg. 2018 Jul 1;27(1):67-74. doi: 10.1093/icvts/ivy030.
Our goal was to validate the Swedish Cardiac Surgery Registry by reviewing the reported cardiac operations to assess the completeness and quality of the registered data and the EuroSCORE II variables.
A total of 5837 cardiac operations were reported to the Swedish Cardiac Surgery Registry in Sweden during 2015. A randomly selected sample of 753 patient records (13%) was scrutinized by 3 surgeons at all 8 units in Sweden performing open cardiac surgery in adults.
Coverage was excellent with 99% [95% confidence interval (CI) 98-99%] of the performed procedures found in the registry. Reported waiting times for surgery were correct in 78% (95% CI 76-79%) of the cases. The main procedural code was correctly reported in 96% (95% CI 95-97%) of the cases. The correlation between reported and monitored logistic EuroSCORE II had a coefficient of 0.79 (95% CI 0.76-0.82), and the median difference in EuroSCORE II was 0% (interquartile range -0.4% to 0.4%). The majority of EuroSCORE II variables had good agreement and coherence; however, New York Heart Association functional class, preoperative renal dysfunction, left ventricular ejection fraction, Canadian Cardiovascular Society Class IV angina and poor mobility were less robust. Postoperative complications were rare and in general had a high degree of completeness and agreement.
The reliability of the variables in the national Swedish Cardiac Surgery Registry was excellent. Thus, the registry is a valuable source of data for quality studies and research. Some EuroSCORE II variables require improved and stricter definitions to obtain uniform reporting and high validity.
我们的目标是通过审查报告的心脏手术来验证瑞典心脏手术登记处，以评估注册数据以及欧洲心脏手术风险评估系统II（EuroSCORE II）变量的完整性和质量。
2015年期间，瑞典共有5837例心脏手术报告给了瑞典心脏手术登记处。在瑞典所有8个开展成人心脏直视手术的单位中，3位外科医生对随机抽取的753份患者记录样本（13%）进行了详细审查。
登记处的覆盖情况极佳，99%[95%置信区间（CI）98 - 99%]的已实施手术在登记处被找到。78%（95%CI 76 - 79%）的病例报告的手术等待时间正确。96%（95%CI 95 - 97%）的病例主要手术编码报告正确。报告的与监测的逻辑EuroSCORE II之间的相关性系数为0.79（95%CI 0.76 - 0.82），EuroSCORE II的中位数差异为0%（四分位间距为 - 0.4%至0.4%）。大多数EuroSCORE II变量具有良好的一致性和连贯性；然而，纽约心脏协会心功能分级、术前肾功能不全、左心室射血分数、加拿大心血管学会IV级心绞痛和活动能力差等方面的情况不太可靠。术后并发症很少见，总体上具有高度的完整性和一致性。
瑞典国家心脏手术登记处变量的可靠性极佳。因此，该登记处是质量研究和科研的宝贵数据来源。一些EuroSCORE II变量需要改进并采用更严格的定义，以实现统一报告并提高有效性。
