Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.
Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden.
World J Surg. 2021 Jun;45(6):1622-1629. doi: 10.1007/s00268-021-06094-4. Epub 2021 Apr 7.
This study aims to assess patient coverage, validity and data quality in the Swedish part of the International Enhanced Recovery After Surgery (ERAS) Interactive Audit System (EIAS).
All Swedish ERAS centers that recorded colorectal surgery data in EIAS between January 1, 2017, and December 31, 2017, were included (N = 12). Information registered in EIAS was compared with data from electronic medical records at each hospital to assess the overall coverage of EIAS. Twenty random-selected patients from each of the contributing centers were assessed for accuracy for a set of clinically relevant variables. All patients admitted to the contributing centers were included for the assessment of rate of missing on a selection of key clinical variables.
Eight hospitals provided complete information for the evaluation, while four hospitals only allowed assessment of coverage and missing data. The eight hospitals had an overall coverage of 98.8% in EIAS (n = 1301) and the four 86.7% (n = 811). The average agreement for the assessed postoperative outcome variables was 96.5%. The accuracy was excellent for 'length of hospital stay,' 'reoperation,' and 'any complications,' but lower for other types of complications. Only a few variables had more than 5% missing data, and missingness was associated with hospital type and size.
This validation of the Swedish part of the international ERAS database suggests high patient coverage in EIAS and high agreement and limited missingness in clinically relevant variables. This validation approach or a modified version can be used for continued validation of the International ERAS database.
本研究旨在评估瑞典参与的国际增强型术后恢复（ERAS）交互式审核系统（EIAS）中的患者覆盖范围、有效性和数据质量。
纳入 2017 年 1 月 1 日至 12 月 31 日期间在 EIAS 中记录结直肠手术数据的所有瑞典 ERAS 中心（N=12）。将 EIAS 中注册的信息与每家医院的电子病历进行比较，以评估 EIAS 的总体覆盖范围。从每个参与中心随机选择 20 名患者，评估一组临床相关变量的准确性。对于一组关键临床变量，纳入所有被纳入参与中心的患者以评估缺失率。
8 家医院提供了完整的评估信息，而 4 家医院仅允许评估覆盖范围和缺失数据。这 8 家医院的 EIAS 总体覆盖率为 98.8%（n=1301），而这 4 家医院的覆盖率为 86.7%（n=811）。评估的术后结局变量的平均一致性为 96.5%。“住院时间”、“再次手术”和“任何并发症”的准确性非常好，但其他类型的并发症的准确性较低。只有少数变量缺失数据超过 5%，且缺失数据与医院类型和规模相关。
对国际 ERAS 数据库瑞典部分的验证表明，EIAS 中患者的覆盖范围高，且在临床相关变量中具有高度一致性和有限的缺失率。此验证方法或经修改的版本可用于国际 ERAS 数据库的持续验证。
