Treatment of aortic aneurysms registered in Swedvasc

Abstract

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.

Association of women-specific size threshold and mortality in elective abdominal aortic aneurysm repair

“…The external and internal validity of the Swedish national quality registry for vascular procedures has been high (98.8% and 96.2%, respectively) 19 , 26 , 27 . Previous internal validation has included the diameter variable 26 , 27 , and a core lab was not used for further validation within the scope of this study.…”

“…In order to strengthen the evidence-base and improve the quality of vascular services offered to women with AAAs worldwide, it is necessary to scrutinize the outcomes of women presenting with small and large AAAs at the time of elective treatment (as compared to the current threshold for men, 55 mm). National quality registries provide an excellent platform for such analyses 19 . To date, the topic of mortality rates among women treated at different AAA diameters has only briefly been mentioned in the observational literature 20 .…”