Bergqvist D, Mani K, Troëng T, Wanhainen A
1Department of Surgical Sciences, Vascular Surgery, Academic Hospital, 75185 Uppsala, Sweden.
2Section of Vascular Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Gefasschirurgie. 2018;23(5):340-345. doi: 10.1007/s00772-018-0414-8. Epub 2018 Aug 13.
Swedvasc is a registry for vascular surgical procedures, both open and endovascular. It was started in 1987 and since 1994 the whole population of Sweden is covered, at present around 10 million inhabitants. In a recent external validation, it was found to be highly accurate with abdominal aortic aneurysm surgery correctly reported in >96%. In this paper various factors explaining the almost 100% coverage are discussed, one important being that the registry has been developed and maintained within the profession of vascular surgery and not dictated by authorities. Another factor of importance is the possibility to use data in various research projects and so far 15 PhD theses have used Swedvasc data. To exemplify the practical use of the registry, the treatment of abdominal aortic aneurysms is scrutinized and among the various complications abdominal compartment syndrome is analyzed. Several significant temporal changes have been observed over the almost 25 years of Swedvasc: increasing use of endovascular surgery, treatment of aneurysms detected by screening , decreasing treatment for rupture, improved outcome, increasing treatment of older patients and patients with comorbid conditions. In conclusion, a high quality national vascular registry can be valid with high compliance and can be used to study population-based development of treatment and outcome. It can also be used to perform international comparisons with other registries, thereby getting an indication of the quality of care.
瑞典血管外科注册系统（Swedvasc）是一个涵盖开放和血管腔内血管外科手术的注册系统。它始于1987年，自1994年起覆盖瑞典全体人口，目前约有1000万居民。在最近的一次外部验证中，发现该系统高度准确，腹主动脉瘤手术的正确报告率超过96%。本文讨论了解释几乎100%覆盖率的各种因素，其中一个重要因素是该注册系统是在血管外科专业内部开发和维护的，而非由当局规定。另一个重要因素是在各种研究项目中使用数据的可能性，到目前为止已有15篇博士论文使用了瑞典血管外科注册系统的数据。为举例说明该注册系统的实际应用，对腹主动脉瘤的治疗进行了详细审查，并分析了各种并发症中的腹腔间隔室综合征。在瑞典血管外科注册系统近25年的时间里观察到了几个显著的时间变化：血管腔内手术的使用增加、筛查发现的动脉瘤的治疗、破裂治疗的减少、预后改善、老年患者和合并症患者治疗的增加。总之，一个高质量的国家血管注册系统可以具有高依从性且有效，可用于研究基于人群的治疗和预后发展。它还可用于与其他注册系统进行国际比较，从而了解医疗质量情况。
