Nilsson E, Kald A, Anderberg B, Bragmark M, Fordell R, Haapaniemi S, Heuman R, Lindhagen J, Stubberöd A, Wickbom J
Department of Surgery at the Hospital of Motala, Sweden.
Eur J Surg. 1997 Nov;163(11):823-9.
To establish a register of inguinal hernia surgery that allows audit and analyses of data from several centres.
Prospective recording of data on a common protocol.
Eight Swedish hospitals.
All groin hernia operations done for patients over 15 years old from January 1992 to December 1994.
Methods of repair, postoperative complications including mortality, day surgery rate, and reoperations for recurrence.
During the three years studied 4879 hernia operations were undertaken in 4474 patients. Postoperative mortality within 30 days of operation for emergency and elective hernia repairs was 3.5% and 0.07%, respectively. Of all herniorrhaphies 798 (16%) were done for recurrences, 142 of these after operations between 1992 and 1994. At 24 months 4% of all operations had been redone because of recurrences with highly significant variations among hospitals ranging from 1.5% to 6.7%. Postoperative complications within 30 days after operation, direct hernia, recurrent hernia, and the use of absorbable sutures were associated with an increased risk of reoperation.
A quality register recorded voluntarily can identify significant interhospital differences in outcome as well as variables associated with an increased risk of reoperation, thereby raising quality awareness and facilitating the process of improvement.
建立一个腹股沟疝手术登记系统，以便对来自多个中心的数据进行审计和分析。
按照通用方案进行前瞻性数据记录。
瑞典的八家医院。
1992年1月至1994年12月期间为15岁以上患者进行的所有腹股沟疝手术。
修复方法、术后并发症（包括死亡率）、日间手术率以及复发后的再次手术情况。
在研究的三年中，对4474例患者进行了4879例疝手术。急诊和择期疝修补术后30天内的死亡率分别为3.5%和0.07%。在所有疝修补术中，798例（16%）是针对复发性疝进行的，其中142例是在1992年至1994年的手术之后复发的。在24个月时，所有手术中有4%因复发而再次进行，各医院之间差异极显著，范围从1.5%至6.7%。术后30天内的术后并发症、直疝、复发性疝以及使用可吸收缝线与再次手术风险增加相关。
自愿记录的质量登记系统可以识别医院之间在治疗结果方面的显著差异以及与再次手术风险增加相关的变量，从而提高质量意识并促进改进过程。
