A continuous record of postoperative surgical infections was carried out by electronic data processing of 9,181 orthopaedic and general operations. The overall infection rate was 5.7%, ranging from 2.0% (clean wounds) to 22.1% (dirty wounds). The corresponding deep infection rates were 1.7%, 0.4% and 5.4%, respectively. Employing a multiple logistic regression analysis, ten risk factors were evaluated. Factors found to be significant for both departments were: wound contamination, duration of operation and age. In addition, in the department of orthopaedic surgery: date of operation and surgeon, and in the department of general surgery: planning of operation, length of preoperative stay and anatomic groups. Sex had no influence on postoperative infection. Significant factors altered during the four years. Postoperative stay was, on an average, 13.9 days longer in infected patients.
To improve the frequency of primary registration and reduce the time spent on continuous registration of postoperative wound infections by electronic data processing (EDP), we analysed the failures made during a two year period, where and by whom they were made. 16.9% of the operations and 0.4% of the infections had not been registered primarily, and all involved groups had made mistakes, but the surgeons were responsible for 69.2% of the missing registrations. This study shows that reliable registration of infections requires frequent instruction of all groups, especially the surgeons, frequent reports of infections in the ward and for each surgeon, and that the registrations are continuously controlled and at the end of year.
A questionnaire concerning the training of future radiologists and factors affecting the quality of specialist training was sent to the heads of all radiological departments participating in the training program in Denmark. The answers showed that the quality of training and of radiological production were suffering due to increasing numbers of investigations and administrative demands without a corresponding increase in resources.
BACKGROUND: We studied the referrals for intravenous urography and their outcome during the year 2000 in a university department before the switch to unenhanced computed tomography (CT) and CT urography. METHODS: From the Radiology Information System, we obtained information about age, sex, referring physician, indication, and diagnosis. RESULTS: A total of 1229 intravenous urographies was performed in 1164 patients. In patients younger than 40 years, females were examined more frequently than males, and vice versa. Forty-five percent of all patients were referred with renal colic, and 41% were referred with hematuria. Renal colic was a more frequent indication than hematuria in patients younger than 61 years, whereas the opposite was the case in patients older than 60 years. Of the 559 urographies performed due to renal colic, a calculus in the upper urinary tract was found in 27% and a change indicating a tumor in 4%; the incidence of calculus increased with age up to 80 years. Of the 487 urographies performed due to hematuria, a calculus in the upper urinary tract was found in 6% and a change indicating a tumor in 15%. In the 277 patients younger than 40 years, an abnormality was diagnosed in 25% and a potential tumor was diagnosed in only 1.4%. The latter could not be confirmed at other examinations. Of the 887 patients older than 40 years, an abnormality was found in 45% and a potential tumor in 11%. CONCLUSION: A switch from urography to unenhanced CT and CT urography should not be done without an audit of the referrals and their outcomes. Patients with hematuria and younger than 40 years seem more appropriate for ultrasound than for CT because the incidence of tumors and calculus disease is low. No transitional cellular cancer was found in these patients.
In a series of 128 patients operated for gastric cancer, 27 were microscopically radically resected. The median age of the microscopically radically resected patients was 72.3 years (36-84) at operation, the median observation time was 3.8 years, the crude 5-year survival was 48.2%, and the median hospital stay after operation was 12.9 days. The older patients did remarkably well. We found no significant difference in the number of survivors, survival/observation time or hospital stay between the age groups 55-64, 65-74 or 75-84 years. Thus age in its own right should be no barrier when curative surgical treatment seems possible. When the study was closed, 12 of the 27 microscopically radically resected patients were still alive, six had died from recurrence of gastric cancer and nine from other causes. Instead of crude survival, we suggest the results stated in estimates of cancer deaths prevented. Five years after microscopically radical resection for gastric cancer, 77.1% of the patients had not died from gastric cancer (Kaplan-Meier life table).