Surgery was successful – but how did it go for the patient? Experiences from and hopes for the Swedish Perioperative Register

Chew, Michelle; Mangelus, Claes; Enlund, Gunnar; Spetz, Peter; Lyckner, Sara

doi:10.1097/eja.0000000000000283

Cited by 7 publications

(7 citation statements)

References 2 publications

(2 reference statements)

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“…There are several limitations of this study. This is a retrospective register study, data derived from the relatively new Swedish perioperative register, SPOR-register 9 . Registers are dependent on input and data-management, and we are aware that a number of patients were excluded in the analysis of outcome due to missing information.…”

Section: Discussionmentioning

confidence: 99%

Acute hip fracture surgery anaesthetic technique and 30-day mortality in Sweden 2016 and 2017: A retrospective register study

Gremillet

Jakobsson

2018

F1000Res

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Background: Hip fractures affect 1.6 million patients yearly worldwide, often elderly with complex comorbidity. Mortality following surgery for acute hip fracture is high and multifactorial; high age, comorbidities and complication/deterioration in health following surgery. Whether the anaesthesia technique affects the 30-day mortality rate has been studied widely without reaching a consensus. The primary aim of this study was to determine anaesthetic techniques used in Sweden and their impact on the 30-day mortality rate in elderly undergoing acute hip fracture surgery. Other aims were to study the impact of age, gender, ASA class, fracture type and delay in surgery on the 30-day mortality rate. Methods: Data from 13,649 patients ≥50 years old who had undergone acute hip fracture surgery and been reported to Swedish perioperative register (SPOR) between 2016 and 2017 were analysed. Results: The most commonly used anaesthetic technique was neuraxial anaesthesia (NA; 11,257, 82%), followed by general anaesthesia (GA; 2,190, 16%) and combined general and neuraxial anaesthesia (CA; 202, 1.5%) out of the 13,649 studied. The 30-day mortality rate was 7.7% for the entire cohort; GA 7.8%, NA 7.7% and CA 7.4%. Mortality was higher in elderly patients, those with a high ASA class, pertrochanteric fracture and males. Conclusions: The present study showed that NA is by far the most common anaesthetic technique for acute hip fracture surgery in Sweden. However, the anaesthetic technique used during this type of surgery had no impact on the 30-day mortality rate in patients. Increasing age, ASA class and male gender increased the 30-day mortality.

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Section: Discussionmentioning

confidence: 99%

Acute hip fracture surgery anaesthetic technique and 30-day mortality in Sweden 2016 and 2017: A retrospective register study

Gremillet

Jakobsson

2018

F1000Res

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“…In an editorial, SPOR was just described in brief. 1 In previously published articles based on SPOR data, this information has not been presented. [2][3][4] A second aim is to verify the accuracy of this database information, supporting its use in the assessment of national surgical capacity or for daily planning in surgical theatres.…”

Section: Aimsmentioning

confidence: 99%

“…The first aim of this article is to describe the development and maintenance of SPOR in detail. In an editorial, SPOR was just described in brief 1 . In previously published articles based on SPOR data, this information has not been presented 2–4 …”

Section: Introductionmentioning

confidence: 99%

The Swedish Perioperative Register: Description, validation of data mapping and utility

Holmström

Enlund

Spetz

et al. 2022

Acta Anaesthesiol Scand

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Background: Since 2013 surgical units in Sweden have reported procedures to the national Swedish Perioperative Register (SPOR). More than four million cases have been documented. Data consist of patient ID, type of surgery, diagnoses, time stamps during the perioperative process (from the decision to operate to the time of discharge from the postoperative recovery area) and quality measures. This article aims to describe SPOR and validate data mapping. Also, we wished to illustrate the utility of the SPOR in assessing variations in national surgical capacity during the COVID-19 pandemia years 2020-2021.Methods: After a detailed description of SPOR, we report on the validation of data performed by comparing data from local databases with data stored in the central SPOR database, assessing missing values and accuracy. Effects of the pandemic on surgical capacity were described by developing an index, based on the number of performed surgical procedures per week during four production weeks in January 2020. Subsequent weeks were then compared with this baseline. Results:The validation effort demonstrated nearly 100% data accuracy for the number and type of surgical procedures between local and central data. Missing data was a problem for some parameters. The number of performed surgical procedures decreased dramatically from week 11 in 2020 compared with normal production on a national basis, mainly impairing elective surgery.Discussion: Data validation revealed good agreement between local and central databases. The changes in national surgical capacity during the pandemic were illustrated by an index based on the reported surgical production.

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“…The Swedish Perioperative Registry (SPOR) contains data on virtually all performed surgeries in Sweden. 6 An important purpose of the registry is to enable regional and national comparisons, and therefore, enhance the quality of anesthesia and surgical care in the Swedish healthcare system. In the context of our study, SPOR provides a unique opportunity to present actual outcomes in regard to pediatric anesthesia and surgery on a nationwide scale.…”

Section: Introductionmentioning

confidence: 99%

“…The Swedish Perioperative Registry (SPOR) contains data on virtually all performed surgeries in Sweden 6 . An important purpose of the registry is to enable regional and national comparisons, and therefore, enhance the quality of anesthesia and surgical care in the Swedish healthcare system.…”

Section: Introductionmentioning

confidence: 99%

The COVID‐19 pandemic first wave in Sweden: A national registry study of the effects on pediatric anesthesia and surgery

Melander

Almström

Enlund

et al. 2021

Pediatric Anesthesia

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Background The COVID‐19 pandemic is pushing healthcare systems to their limits. Dramatic reductions in the adult elective surgery are ubiquitous, but corresponding changes in pediatric services are not well described. The Swedish Perioperative Registry contains data on all anesthetic procedures in Sweden, and therefore, provides a unique opportunity to analyze the effect of the pandemic on the pediatric anesthesia capacity on a national level. We hypothesized that there would be a significant reduction in pediatric elective procedures. The aim was to determine the effects on pediatric surgical and anesthetic services during the first wave of the COVID‐19 pandemic in Sweden. Methods For this retrospective registry cohort study, we extracted all procedures performed on patients <18 years of age in 2020 and 2019. Weeks 12 to 26 of 2020 were defined as the first wave, and data were analyzed according to level of care, type of surgery, procedure code, and emergency or elective surgery. Results We found 7015 fewer procedures during the first wave epoch. Elective cases were reduced by 53.7% while emergency surgery was not significantly affected. During the peak of the first wave in April, there was a 72.8% reduction in elective cases; ENT/maxillofacial surgery showed the greatest reduction (86.7%). The surgical and anesthesia capacity recovered to near‐normal levels by the end of June 2020. Conclusion We conclude that the impact of COVID‐19 on pediatric surgical procedures in Sweden during the first wave of the pandemic was dramatic, but elective services were restored a few months after the peak.

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Surgery was successful – but how did it go for the patient? Experiences from and hopes for the Swedish Perioperative Register

Cited by 7 publications

References 2 publications

Acute hip fracture surgery anaesthetic technique and 30-day mortality in Sweden 2016 and 2017: A retrospective register study

Acute hip fracture surgery anaesthetic technique and 30-day mortality in Sweden 2016 and 2017: A retrospective register study

The Swedish Perioperative Register: Description, validation of data mapping and utility

The COVID‐19 pandemic first wave in Sweden: A national registry study of the effects on pediatric anesthesia and surgery

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