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81 records – page 1 of 9.

[Accelerated recovery program after hip fracture surgery]

https://arctichealth.org/en/permalink/ahliterature61643
Source
Ugeskr Laeger. 2002 Dec 30;165(1):29-33
Publication Type
Article
Date
Dec-30-2002
Author
Sten Rasmussen
Billy B Kristensen
Susanne Foldager
Lis Myhrmann
Henrik Kehlet
Author Affiliation
Ortopaedkirurgisk afdeling, Vejle Sygehus, DK-7300 Vejle. sten.rasmussen@dadlnet.dk
Source
Ugeskr Laeger. 2002 Dec 30;165(1):29-33
Date
Dec-30-2002
Language
Danish
Publication Type
Article
Keywords
Aged
Arthroplasty, Replacement, Hip - methods - rehabilitation
Comparative Study
Denmark
Early Ambulation - methods
English Abstract
Female
Hip Fractures - rehabilitation - surgery
Humans
Length of Stay - statistics & numerical data
Male
Middle Aged
Postoperative Care - methods
Preoperative Care - methods
Prospective Studies
Recovery of Function
Research Support, Non-U.S. Gov't
Retrospective Studies
Abstract
INTRODUCTION: A multimodal approach to minimise the effect of the surgical stress response can reduce complications and hospital stay after abdominal surgery and hip arthroplasty. The aim of the study was to assess the results of a well-defined rehabilitation programme after hip fracture. MATERIAL AND METHODS: In an open intervention study, we entered 200 consecutive patients with hip fracture allowing full weight-bearing after operative treatment. The effect of a revised, optimised perioperative care programme with continuous epidural analgesia, early oral nutrition, oxygen supplementation, restricted volume and transfusion therapy, and intensive physiotherapy and mobilisation was assessed (n = 100) and compared with the conventional perioperative treatment programme before the intervention (n = 100). The median age was 82 (56-96) years in the control group and 82 (63-101) years in the accelerated multimodal perioperative treatment group. RESULTS: The median hospital stay was reduced from 21 (range 1-162, mean 32) to 11 (range 1-100, mean 17) days. The total use of days in hospital was reduced from 3211 to 1667. There were fewer complications, whereas the need for home care after discharge was unchanged. CONCLUSION: An accelerated clinical pathway with focus on pain relief, oral nutrition, and rehabilitation may reduce hospital stay and improve recovery after hip fracture.
PubMed ID
12529945 View in PubMed
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[Accelerated versus conventional hospital stay in total hip and knee arthroplasty II: organizational and clinical differences].

https://arctichealth.org/en/permalink/ahliterature168857
Source
Ugeskr Laeger. 2006 May 29;168(22):2144-8
Publication Type
Article
Date
May-29-2006
Author
Henrik Husted
Hans Christian Hansen
Gitte Holm
Charlotte Bach-Dal
Kirsten Rud
Kristoffer Lande Andersen
Henrik Kehlet
Author Affiliation
H:S Hvidovre Hospital, Ortopaedkirurgisk Afdeling, Hvidovre. henrikhusted@dadlnet.dk
Source
Ugeskr Laeger. 2006 May 29;168(22):2144-8
Date
May-29-2006
Language
Danish
Publication Type
Article
Keywords
Arthroplasty, Replacement, Hip - nursing - rehabilitation - statistics & numerical data
Arthroplasty, Replacement, Knee - nursing - rehabilitation - statistics & numerical data
Denmark
Early Ambulation - statistics & numerical data
Focus Groups
Hospital Departments - organization & administration - statistics & numerical data
Humans
Interviews as Topic
Length of Stay
Orthopedics - organization & administration - statistics & numerical data
Patient Discharge - statistics & numerical data
Physician's Practice Patterns
Registries
Abstract
The goal of this study was to evaluate hospital stays for patients operated on with primary total hip- and knee-arthroplasty (THA and TKA) in order to identify important logistical and clinical areas for the duration of the hospital stay.
According to the National Register on Patients, the three departments with the shortest and the three departments with the longest postoperative hospital stay at the end of 2003 were chosen for evaluation. This took place from late 2004 to mid 2005, and all written material and 25 journals from each department were evaluated, and interviews with the heads of the departments as well as the staff were conducted. The logistical set-up and the clinical treatment/pathway were examined in an attempt to identify logistical and clinical factors acting as improvements or barriers for quick rehabilitation and subsequent discharge.
Departments with short hospital stay were characterised by both logistical (homogenous entities, regular staff, high continuity, using more time on and up-to-date information including expectations of a short stay, functional discharge criteria) and clinical features (multi-modal pain treatment, early mobilization and discharge when criteria were met) facilitating quick rehabilitation and discharge.
Implementation of logistical and clinical features, as shown in this study in all departments, are expected to increase rehabilitation and reduce the length of hospital stay.
PubMed ID
16768951 View in PubMed
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Accuracy of the Danish version of the 'distress thermometer'.

https://arctichealth.org/en/permalink/ahliterature137474
Source
Psychooncology. 2012 Apr;21(4):436-43
Publication Type
Article
Date
Apr-2012
Author
Pernille Envold Bidstrup
Birgitte Goldschmidt Mertz
Susanne Oksbjerg Dalton
Isabelle Deltour
Niels Kroman
Henrik Kehlet
Nina Rottmann
Rune Gärtner
Alex J Mitchell
Christoffer Johansen
Author Affiliation
Department of Psychosocial Cancer Research, Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark. pernille@cancer.dk
Source
Psychooncology. 2012 Apr;21(4):436-43
Date
Apr-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Anxiety - diagnosis
Breast Neoplasms - psychology
Denmark
Depression - diagnosis
Female
Humans
Middle Aged
Predictive value of tests
Psychometrics - instrumentation
Questionnaires
Sensitivity and specificity
Stress, Psychological - diagnosis
Abstract
Short screening instruments have been suggested to improve the detection of psychological symptoms. We examined the accuracy of the Danish version of the 'Distress Thermometer'.
Between October 2008 and October 2009, 426 women with newly diagnosed primary breast cancer who were operated at the Breast Surgery Clinic of the Rigshospitalet, Copenhagen, were eligible for this study. Of these, 357 participated (84%) and 333 completed a questionnaire. The distress thermometer was evaluated against the 'hospital anxiety and depression scale' (HADS). We also examined the women's wish for referral for psychological support.
A cut-off score of 6 vs 7 (low: =6, high: =7) on the distress thermometer was optimal for confirming distress, with a sensitivity of 42%, a specificity of 93%, a positive predictive value (PPV) of 78% and a negative predictive value (NPV) of 73%. A cut-off score of 2 vs 3 was optimal for screening, with a sensitivity of 99%, a specificity of 36%, a PPV of 47% and a NPV of 99%. Of those who were distressed using the cut-off score of 2 vs 3 on the distress thermometer, 17% (n = 41) wished to be referred for psychological support and 57% (n = 140) potentially wanted a later referral.
The distress thermometer performed satisfactorily relative to the HADS in detecting distress in our study. A screening procedure in which application of the distress thermometer is a first step could be useful for identifying persons in need of support.
PubMed ID
21280139 View in PubMed
Less detail
Source
Ugeskr Laeger. 2008 Dec 8;170(50):4113-6
Publication Type
Article
Date
Dec-8-2008
Author
Jan Viberg Jepsen
Bjarne Kromann-Andersen
Anette Bendixen
Jørgen Norling
Henrik Kehlet
Author Affiliation
Urologisk Afdeling, Herlev Hospital, DK-2730 Herlev. JAVIJE02@heh.regionh.dk
Source
Ugeskr Laeger. 2008 Dec 8;170(50):4113-6
Date
Dec-8-2008
Language
Danish
Publication Type
Article
Keywords
Adrenalectomy - adverse effects - methods - mortality
Denmark - epidemiology
Humans
Laparoscopy
Length of Stay
Outcome Assessment (Health Care)
Postoperative Complications - epidemiology - mortality
Risk factors
Abstract
Laparoscopic adrenalectomy is replacing open adrenalectomy. The advantages are reduced mortality and morbidity, and shorter postoperative hospitalisation. The organization and short-term outcomes of adrenalectomy in Denmark are largely unknown.
Extraction, review, and analysis of data from the National Patient Register and discharge notes from 2002-2006.
A total of 297 adrenalectomies, of which 161 were laparoscopic, were identified. Discharge notes were reviewed in 221 of these cases (2002-2005). All except three were performed in a university hospital setting. The laparoscopic to open conversion rate was 7.6%, mortality 1%, and complication rates for open/laparoscopic adrenalectomy 25%/16%. The mean postoperative hospital stays on surgical/urological wards were 6.0/2.9 days for open and laparoscopic procedures, respectively.
In Denmark, the share of adrenalectomies performed laparoscopically is growing, currently reaching about 65%. Laparoscopic adrenalectomies are only performed at departments with a high frequency of laparoscopic surgery and specialized endocrinological and anaesthesiological support. For educational and research purposes, adrenalectomy should be performed at an even smaller number of departments. Postoperative hospital stay and mortality are at par with internationally reported levels, but the conversion rate of laparoscopic adrenalectomies should be reduced.
PubMed ID
19091188 View in PubMed
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Aetiology, treatment and mortality after oesophageal perforation in Denmark.

https://arctichealth.org/en/permalink/ahliterature134855
Source
Dan Med Bull. 2011 May;58(5):A4267
Publication Type
Article
Date
May-2011
Author
Philip Ryom
Jesper Bohsen Ravn
Luit Penninga
Susanne Schmidt
Maria Gerding Iversen
Peter Skov-Olsen
Henrik Kehlet
Author Affiliation
Thoracic Surgery Department, Rigshospitalet, Blegdamsvej 9, Copenhagen, Denmark. philip.ryom@regionh.rh.dk
Source
Dan Med Bull. 2011 May;58(5):A4267
Date
May-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Catheterization - adverse effects
Child
Child, Preschool
Denmark
Dilatation - adverse effects
Esophageal Perforation - etiology - mortality - therapy
Esophagoscopy - adverse effects - instrumentation
Female
Humans
Infant
Intubation, Gastrointestinal - adverse effects
Length of Stay
Male
Middle Aged
Retrospective Studies
Rupture, Spontaneous - complications
Young Adult
Abstract
Perforation of the oesophagus into the thoracic cavity is a potentially life-threatening condition. The causes are numerous. Treatment for oesophageal perforation targets mediastinal and pleural contamination. Present knowledge about the causes of perforation and the types of treatment is poor.
A retrospective review was made between 1997 and 2005 based on extracts from the National Patient Registry.
A total of 286 patients were diagnosed with perforation of the oesophagus (131 women and 155 men). Their average age was 60 years. A wide spectrum of causes was reported, e.g. instrumentation of the oesophagus 136 (47.6%), spontaneous rupture 89 (31.1%) or procedures otherwise related to surgical intervention 9 (3.1%). One third of the patients started conservative treatment 91 (31.9%). The majority of the patients were transferred to a thoracic surgery department for further treatment: about 25% of patients underwent surgery. The average hospitalization time was 18 days. The mortality rate was 21%.
Oesophageal perforation remains a diagnostic and therapeutic challenge and the condition requires aggressive treatment. Recent consensus in early treatment with thoracotomy, debridement, irrigation and subsequent parenteral nutrition has improved survival. In this material, most perforations were iatrogenic in nature. In the 2002-2005 period, the study showed that 29% of the iatrogenic perforations were caused by the use of a rigid endoscope which is risky and whose use should therefore be restricted. It is advisable to set up national guidelines for treatment of oesophageal perforation and to centralise treatment.
PubMed ID
21535984 View in PubMed
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Anaemia impedes functional mobility after hip fracture surgery.

https://arctichealth.org/en/permalink/ahliterature158227
Source
Age Ageing. 2008 Mar;37(2):173-8
Publication Type
Article
Date
Mar-2008
Author
Nicolai B Foss
Morten Tange Kristensen
Henrik Kehlet
Author Affiliation
Department of Anaesthesia, Hvidovre University Hospital, Hvidovre, Denmark. nbf@comxnet.dk
Source
Age Ageing. 2008 Mar;37(2):173-8
Date
Mar-2008
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Anemia - complications - diagnosis - therapy
Blood Transfusion
Cohort Studies
Denmark
Female
Fracture Fixation, Internal - adverse effects - methods - mortality
Hemoglobins - analysis
Hip Fractures - mortality - rehabilitation - surgery
Humans
Male
Perioperative Care - methods
Physical Therapy Modalities
Prognosis
Prospective Studies
Recovery of Function
Risk assessment
Survival Rate
Walking - physiology
Abstract
the impact of anaemia on the outcome after a hip fracture surgery is controversial, but anaemia can potentially decrease the physical performance and thereby impede post-operative rehabilitation. We therefore conducted a prospective study to establish whether anaemia affected functional mobility in the early post-operative phase after a hip fracture surgery.
four hundred and eighty seven consecutive hip fracture patients, treated according to a well-defined multimodal rehabilitation programme with a uniform, liberal transfusion threshold, were studied. Hb was measured on each of the first three post-operative days, and anaemia defined as Hb
PubMed ID
18349013 View in PubMed
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[Bariatric surgery in Denmark--are we on the right way?].

https://arctichealth.org/en/permalink/ahliterature153608
Source
Ugeskr Laeger. 2008 Dec 8;170(50):4128-30
Publication Type
Article
Date
Dec-8-2008
Author
Peter Funch-Jensen
Maria Gerding Iversen
Henrik Kehlet
Author Affiliation
Sundhedsstyrelsen, Monitorering og Medicinsk Teknologivurdering, Islands Brygge 67, DK-2300 København S. mgi@sst.dk.
Source
Ugeskr Laeger. 2008 Dec 8;170(50):4128-30
Date
Dec-8-2008
Language
Danish
Publication Type
Article
Keywords
Bariatric Surgery - methods - statistics & numerical data - trends
Denmark
Humans
Laparoscopy
Practice Guidelines as Topic
Registries
Abstract
In 2005 the National Board of Health (NBH) published guidelines on bariatric surgery in Denmark. The aim of the present study was to shed light on the national bariatric effort in relation to these guidelines.
The analysis is based on extraction of the following data from the National Patient Registry in the period from 2005 through 2007: annual number of operations, type of operation, laparoscopic versus open procedure. Furthermore, the centres were compared.
A total of 2,098 bariatric procedures were performed in the years 2005 to 2007. Apart from a single operation, all operations were performed at departments selected by the NBH. During the period an increase of approximately 400% in the number of operations was observed, and the rise was largest at the private clinics, which performed approx. 60% of the operations in 2007. Not all public departments fulfilled the recommendation from the NBH of a minimum of 100 annual operations. The proportion of banding procedures performed at private clinics was significantly lower than the proportion performed at public hospitals. Significantly more open operations were performed at private clinics, a tendency which was attributable to the activities of one of the private clinics.
The frequency with which bariatric surgery is performed follows a strongly increasing trend and the procedures are only performed at the public departments selected by the National Board of Health and at the private centres that have entered into an agreement with Danish Regions. Since the operative access and selection of procedures varies between departments we conclude that research should be a firm requirement for all centres, and that research efforts should comprise cooperation concerning the database recommended by the NBH.
PubMed ID
19091192 View in PubMed
Less detail
Source
Ugeskr Laeger. 2010 Oct 11;172(41):2836-9
Publication Type
Article
Date
Oct-11-2010
Author
Niels Kroman
Peer Christiansen
Zubair B Hussain
Henrik Kehlet
Author Affiliation
Rigshospitalet, HovedOrtoCenteret, Brystkirurgisk Afdeling CE, Denmark.
Source
Ugeskr Laeger. 2010 Oct 11;172(41):2836-9
Date
Oct-11-2010
Language
Danish
Publication Type
Article
Keywords
Adult
Axilla - surgery
Breast Neoplasms - diagnosis - surgery
Breast Neoplasms, Male - diagnosis - surgery
Denmark - epidemiology
Female
Humans
Length of Stay
Male
Mastectomy - methods - statistics & numerical data
Mastectomy, Segmental
Middle Aged
Outcome Assessment (Health Care)
Postoperative Complications - mortality
Sentinel Lymph Node Biopsy
Abstract
Surgical treatment for breast cancer is changing towards less extensive procedures and hence the need for hospitalisation is reduced. In order to investigate the organisation of such procedures, the choice of surgical procedures, length of hospitalisation, and mortality were evaluated using information from The National Board of Health.
Mandatory data reported to the Danish National Board of Health for 2008.
A total of 19 units performed 4,000 surgical procedures. Three private care units performed 1.2% of all procedures. No postoperative mortality was registered. Mean length of stay was 2.5 days.
The organisation of breast cancer treatment in public health care in Denmark is satisfactory with high volume units (> 100 women with primary breast cancer per year). It seems possible to aim at further reduction in the mean length of stay moving towards a fast track concept.
PubMed ID
20961504 View in PubMed
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Care principles at four fast-track arthroplasty departments in Denmark.

https://arctichealth.org/en/permalink/ahliterature142504
Source
Dan Med Bull. 2010 Jul;57(7):A4166
Publication Type
Article
Date
Jul-2010
Author
Henrik Husted
Søren Solgaard
Torben B Hansen
Kjeld Søballe
Henrik Kehlet
Author Affiliation
Alloplastiksektionen, Ortopaedkirurgisk Afdeling, Hvidovre Hospital, 2650 Hvidovre, Denmark. henrikhusted@dadlnet.dk
Source
Dan Med Bull. 2010 Jul;57(7):A4166
Date
Jul-2010
Language
English
Publication Type
Article
Keywords
Analgesia - methods - standards
Arthroplasty, Replacement, Hip - methods - standards - statistics & numerical data
Arthroplasty, Replacement, Knee - methods - standards - statistics & numerical data
Denmark
Humans
Length of Stay - statistics & numerical data
Patient Care - standards
Perioperative Care
Venous Thrombosis - prevention & control
Abstract
The goal of this study was to describe the logistic and clinical set-up at four Danish arthroplasty departments offering fast-track surgery.
Based on the National Patient Registry's information on patients who have undergone total hip and knee arthroplasty, four departments were chosen for evaluation in accordance with the following inclusion criteria: documented fast-track surgery with written care plans, a surgical volume of > 450 arthroplasties and short length of stay (LOS) (
PubMed ID
20591341 View in PubMed
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Centralized treatment of advanced stages of ovarian cancer improves survival: a nationwide Danish survey.

https://arctichealth.org/en/permalink/ahliterature137198
Source
Acta Obstet Gynecol Scand. 2011 Mar;90(3):273-9
Publication Type
Article
Date
Mar-2011
Author
Carsten L Fagö-Olsen
Claus Høgdall
Henrik Kehlet
Ib J Christensen
Bent Ottesen
Author Affiliation
Department of Gynecology, Juliane Marie Centre, Copenhagen, Denmark. carsten.lindberg.fagoe-olsen@rh.regionh.dk
Source
Acta Obstet Gynecol Scand. 2011 Mar;90(3):273-9
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Adult
Cancer Care Facilities - organization & administration - statistics & numerical data
Denmark - epidemiology
Disease Progression
Female
Humans
Middle Aged
Neoplasm Staging
Oncology Service, Hospital - organization & administration - statistics & numerical data
Ovarian Neoplasms - epidemiology - pathology - therapy
Patient Selection
Population Surveillance
Primary Health Care
Prognosis
Referral and Consultation - organization & administration - statistics & numerical data
Severity of Illness Index
Survival Rate
Treatment Outcome
Women's health
Abstract
This retrospective, nationwide, observational study was designed to compare treatment in tertiary referral centers vs. regional hospitals on overall survival for patients with stage IIIC and IV ovarian cancer.
The study took place in all gynecological departments in Denmark, involving a total of 1,160 patients with stage IIIC or IV ovarian cancer. Data were extracted for 2,024 patients with all stages of ovarian cancer recorded in the Danish Gynecological Cancer Database between 1 January 2005 and 31 December 2008. The main outcome measure was overall survival.
No difference was found between tertiary centers and regional hospitals with regard to age, body mass index, American Society of Anesthesiologists score or comorbidity. Patients in regional hospitals had poorer Eastern Cooperative Oncology Group performance status, i.e.1.0 vs. 2.0 (p= 0.005). Patients in referral centers presented more often with stage IIIC and IV disease, i.e. 59.7 vs. 51.7% (p
PubMed ID
21306310 View in PubMed
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81 records – page 1 of 9.