Skip header and navigation

Refine By

19 records – page 1 of 2.

International Vascunet Validation of the Swedvasc Registry.

https://arctichealth.org/en/permalink/ahliterature271987
Source
Eur J Vasc Endovasc Surg. 2015 Dec;50(6):802-8
Publication Type
Article
Date
Dec-2015
Author
M. Venermo
T. Lees
Source
Eur J Vasc Endovasc Surg. 2015 Dec;50(6):802-8
Date
Dec-2015
Language
English
Publication Type
Article
Keywords
Aortic Aneurysm, Abdominal - diagnosis - mortality - surgery
Cooperative Behavior
Data Collection - statistics & numerical data
Endarterectomy, Carotid - adverse effects - mortality - statistics & numerical data
Female
Hospitals - statistics & numerical data
Humans
International Cooperation
Male
Medical Records - statistics & numerical data
Quality Indicators, Health Care
Registries - statistics & numerical data
Reproducibility of Results
Sweden
Treatment Outcome
Vascular Surgical Procedures - adverse effects - mortality - statistics & numerical data
Abstract
International comparison of registry data within vascular surgery has previously been published by Vascunet. One of the limitations of such comparisons is data validity and completeness, and meaningful interpretation of differences between countries can only be made if the data are robust within each of the countries studied. The Vascunet collaboration has therefore embarked on a validation exercise of international vascular registry data.
Five out of 20 hospitals performing vascular surgery in Sweden were visited by two international validators. Independent evaluation of the procedures of carotid endarterectomy and infrarenal abdominal aortic aneurysm repair was performed, and local hospital administrative data were compared with Swedvasc registry data. External validation compared the numbers of cases in these two systems of data collection and internal validation compared data accuracy and completeness within individual patient records.
Hospital records identified 335 carotid and 393 abdominal aortic aneurysm (AAA) procedures, whereas Swedvasc identified 331 carotid and 359 AAAs. Nine carotid procedures and 64 AAA procedures were found in hospital administrative data but not in Swedvasc, and 14 carotids and 30 AAAs were found in Swedvasc but not in hospital data. External validity was 100% (95% CI 98.8-100%) for carotids and 98.8% (95% CI 96.9-99.5%) for AAAs. In internal validation, 0.8% of variables were missing in hospital data compared with Swedvasc and 4.2% were missing in Swedvasc compared with hospital data. Data contained within the data fields of Swedvasc and hospital data were the same in 97.4% (95% CI 96.3-98.3%) for carotids and 96.2% (CI 94.9-97.2%) for AAAs.
This study has provided a template for international validation of registry data and has demonstrated that Swedvasc is a highly accurate system of data collection for Swedish vascular surgery.
Notes
Comment In: Eur J Vasc Endovasc Surg. 2015 Dec;50(6):80926507502
PubMed ID
26338474 View in PubMed
Less detail

Open repair of ruptured abdominal aortic aneurysm in patients aged 80 years and older.

https://arctichealth.org/en/permalink/ahliterature130109
Source
Br J Surg. 2011 Dec;98(12):1713-8
Publication Type
Article
Date
Dec-2011
Author
F. Biancari
M. Venermo
Author Affiliation
Department of Surgery, Oulu University Hospital, Oulu, Finland. faustobiancari@yahoo.it
Source
Br J Surg. 2011 Dec;98(12):1713-8
Date
Dec-2011
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Aortic Aneurysm, Abdominal - mortality - surgery
Aortic Rupture - mortality - surgery
Female
Finland - epidemiology
Hospital Mortality
Hospitalization - statistics & numerical data
Humans
Kaplan-Meier Estimate
Male
Postoperative Complications - mortality
Retrospective Studies
Shock - mortality
Abstract
Open repair of ruptured abdominal aortic aneurysm (RAAA) in patients aged 80 years and older may be questioned owing to the patients' high operative risk and short life expectancy.
Data on patients aged at least 80 years, admitted for RAAA at four Finnish university hospitals, were collected and analysed retrospectively.
Three hundred and ten consecutive patients aged 80 years and older with RAAA reached hospital alive; 200 (64·5 per cent) underwent open repair. The number of open repairs increased during the last 5 years (49·0 per cent of the whole series), with no significant increase in the number of patients treated conservatively. The overall in-hospital mortality rate was 72·9 per cent. The operative mortality rate was 59·0 per cent and decreased from 66 to 52 per cent during the last 5 years (P = 0·050). On multivariable analysis, shock was the only independent predictor of immediate postoperative death (odds ratio 4·97, 95 per cent confidence interval 2·09 to7·94; P
PubMed ID
22034180 View in PubMed
Less detail

Indicators for comparing the incidence of diabetic amputations: a nationwide population-based register study.

https://arctichealth.org/en/permalink/ahliterature107437
Source
Eur J Vasc Endovasc Surg. 2013 Nov;46(5):569-74
Publication Type
Article
Date
Nov-2013
Author
K. Winell
M. Venermo
T. Ikonen
R. Sund
Author Affiliation
THL - National Institute for Health and Welfare, Helsinki, Finland. Electronic address: klas.winell@conmedic.fi.
Source
Eur J Vasc Endovasc Surg. 2013 Nov;46(5):569-74
Date
Nov-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Amputation - mortality - statistics & numerical data
Benchmarking - statistics & numerical data
Catchment Area (Health) - statistics & numerical data
Diabetic Foot - diagnosis - mortality - surgery
Female
Finland - epidemiology
Health Status Indicators
Humans
Incidence
Kaplan-Meier Estimate
Male
Middle Aged
Quality Indicators, Health Care - statistics & numerical data
Registries
Time Factors
Treatment Outcome
Abstract
To test various indicators for comparing the outcomes of diabetic foot care.
All 396,317 patients treated with hypoglycaemic medication in Finland were followed up based on nationwide registers on hospital discharges and causes of death during 1997-2007.
The crude and standardized incidences of lower extremity amputations (LEAs), the minor-major ratio of the first LEA and 2-year survival with a preserved leg after the first minor LEA were used as indicators for regional and temporal variation in diabetic foot care.
A total of 13,469 LEAs were recorded in 1997-2007. The standardized population-corrected rate of first major LEA per 100,000 person-years declined from 10.0 (95% CI 9.6-10.5) to 7.3 (6.9-7.6) (p
PubMed ID
24007756 View in PubMed
Less detail

The role of vascular registries in improving the management of abdominal aortic aneurysm.

https://arctichealth.org/en/permalink/ahliterature156516
Source
Scand J Surg. 2008;97(2):146-53; discussion 153
Publication Type
Article
Date
2008
Author
M. Lepäntalo
M. Venermo
S. Laukontaus
I. Kantonen
Author Affiliation
Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland. mauri.lepantalo@hus.fi
Source
Scand J Surg. 2008;97(2):146-53; discussion 153
Date
2008
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal - mortality - surgery
Finland
Humans
Middle Aged
Registries
Abstract
Treatment of abdominal aortic aneurysm (AAA) is one of the vascular surgical index procedures and an important part of the total workload. Whichever way treated, it typically has high mortality and morbidity. Furthermore, endovascular repair is still a relatively new treatment method and under evolution. Therefore continuous quality control with subsequent outcome analysis, benchmarking, intervention and reassessment are mandatory to achieve high level aneurysm care. Vascular registries are tools for this audit. The aim of this review is to focus on the problems and solutions related to attempts to improve the management of abdominal aortic aneurysm with emphasis on the experience gathered in Finland. This includes great variations in dynamics over time in Southern Finland. To control the influence of patient selection and case-mix, total hospital mortality is emphasized as the most appropriate outcome measure of the level of treatment of ruptured abdominal aortic aneurysm (RAAA). Total aneurysm mortality (including total hospital mortality of RAAA and other AAA surgery) is introduced as an outcome measure of vascular service.
PubMed ID
18575034 View in PubMed
Less detail

Predictors of failure of endovascular revascularization for critical limb ischemia.

https://arctichealth.org/en/permalink/ahliterature120792
Source
Scand J Surg. 2012;101(3):170-6
Publication Type
Article
Date
2012
Author
M. Korhonen
K. Halmesmäki
M. Lepäntalo
M. Venermo
Author Affiliation
Department of Radiology, Päijät-Häme Central Hospital, Lahti, Finland. maria.korhonen@helsinki.fi
Source
Scand J Surg. 2012;101(3):170-6
Date
2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Amputation - statistics & numerical data
Angioplasty
Ankle Brachial Index
Chronic Disease
Female
Finland
Follow-Up Studies
Humans
Ischemia - etiology - mortality - surgery
Kaplan-Meier Estimate
Lower Extremity - blood supply - surgery
Male
Middle Aged
Multivariate Analysis
Peripheral Arterial Disease - complications - mortality - surgery
Proportional Hazards Models
Registries
Reoperation - statistics & numerical data
Retrospective Studies
Risk factors
Treatment Failure
Abstract
To characterize predictors of failure when treating critical limb ischemia (CLI) patients with an endovascular intervention as the first-line strategy.
This retrospective, registry-based study included 217 consecutive patients with 240 chronic critically ischemic limbs treated with infrainguinal percutaneous trans-luminal angioplasty (PTA) during 2006-2007 at Helsinki University Central Hospital, Finland. The primary outcome measures were death, major (above-ankle) amputation, and the need for surgical re-intervention within 6 months after the primary procedure. The secondary out-come measures were overall major amputation and survival rates as well as the overall need for surgical or any other (surgical or endovascular) type of re-intervention. Predictors of outcome endpoints were identified with a univariate screen, and a Cox regression model was used in the multivariate analysis.
Compared to ulcer, gangrene was significantly more strongly associated with amputation within 6 months post-procedurally as well as during the whole follow-up period (p = 0.028). The patient's inability to walk upon hospital arrival was a significant predictor of death, amputation and surgical re-intervention. Mediasclerotic ankle-brachial index (ABI) was an independent predictor of amputation as well as endovascular re-interventions.
The strong predictors of poor outcome after endovascular revascularization for patients with CLI are cardiac morbidity, the inability to ambulate upon hospital arrival, and gangrene as a manifestation of CLI. The risk of amputation seems to be significantly higher for gangrene than for ulcer and this matter should be taken into account in the clinical classifications for CLI.
PubMed ID
22968240 View in PubMed
Less detail

The natural course of abdominal aortic aneurysms that meet the treatment criteria but not the operative requirements.

https://arctichealth.org/en/permalink/ahliterature116384
Source
Eur J Vasc Endovasc Surg. 2013 Apr;45(4):326-31
Publication Type
Article
Date
Apr-2013
Author
K. Noronen
S. Laukontaus
I. Kantonen
M. Lepäntalo
M. Venermo
Author Affiliation
Department of Vascular Surgery, Helsinki University Central Hospital (HUCH), P.O. Box 340, 00029 HUS Helsinki, Finland. katariina.noronen@hus.fi
Source
Eur J Vasc Endovasc Surg. 2013 Apr;45(4):326-31
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal - complications - diagnosis - mortality - surgery - therapy
Aortic Rupture - etiology - mortality
Comorbidity
Disease Progression
Disease-Free Survival
Female
Finland
Health status
Hospitals, University
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Patient Selection
Predictive value of tests
Retrospective Studies
Risk assessment
Risk factors
Surgical Procedures, Elective
Time Factors
Treatment Outcome
Treatment Refusal
Vascular Surgical Procedures - adverse effects - mortality
Abstract
Abdominal aortic aneurysms (AAAs) of 55 mm diameter or growth >5 mm in 6 months are commonly accepted treatment criteria. The aim of this study was to establish the outcome of aneurysms that met the treatment criteria but not the operative requirements.
Patients (n = 154) who were declined from operative care of AAA in Helsinki University Central Hospital (HUCH) during 2000-2010 were retrospectively analysed. Reasons for exclusion were identified. The follow-up period extended until the end of April 2012. The rupture rate and mortality were determined. The patients were analysed according to the aneurysm diameter: 55-60, 61-70 and >70 mm.
The reasons for exclusion from operative treatment were cardiorespiratory co-morbidities in 33%, cancer in 8%, overall condition in 33% and patient's choice in 21% of the patients. Regardless of the size of the aneurysm, the cause of death was aneurysm rupture in 43%, which was confirmed either in hospital or in autopsy for 76% of the patients. Of the ruptured aneurysms, 12 were operated of which five survived.
A ruptured aneurysm is the most common cause of death among patients unfit for surgery; this should be considered in the preoperative evaluation process, especially since 5 of the 12 patients survived the ruptured AAA (RAAA) operation.
PubMed ID
23403220 View in PubMed
Less detail

Modified ankle-brachial index detects more patients at risk in a Finnish primary health care.

https://arctichealth.org/en/permalink/ahliterature146887
Source
Eur J Vasc Endovasc Surg. 2010 Feb;39(2):227-33
Publication Type
Article
Date
Feb-2010
Author
N K J Oksala
J. Viljamaa
E. Saimanen
M. Venermo
Author Affiliation
Division of Vascular Surgery, Department of Surgery and Medical School, Tampere University and Tampere University Hospital, Tampere, Finland. niku.oksala@tuubi1.net
Source
Eur J Vasc Endovasc Surg. 2010 Feb;39(2):227-33
Date
Feb-2010
Language
English
Publication Type
Article
Keywords
Aged
Ankle Brachial Index - methods
Atherosclerosis - epidemiology - ultrasonography
Chi-Square Distribution
Cross-Sectional Studies
Female
Finland - epidemiology
Humans
Male
Middle Aged
Peripheral Vascular Diseases - epidemiology - ultrasonography
Predictive value of tests
Prevalence
Prospective Studies
Risk factors
Sensitivity and specificity
Abstract
Despite peripheral arterial disease (PAD), defined as ankle-brachial index (ABI)or=70 years or calf pain during exercise. A total of 817 patients were recruited.
Research methods included interview and Doppler measurement of brachial and ankle pressures.
An ABI(mod)or=1.4 had the strongest association with CVD.
PAD is highly prevalent among patients presenting to primary care. ABI(mod) calculation detects more number of patients at risk at the cost of reduced specificity. The association of high ABI with CVD noted in this study warrants future research for validation.
PubMed ID
19969474 View in PubMed
Less detail

Prevalence and risk factors of PAD among patients with elevated ABI.

https://arctichealth.org/en/permalink/ahliterature158520
Source
Eur J Vasc Endovasc Surg. 2008 Jun;35(6):709-14
Publication Type
Article
Date
Jun-2008
Author
V. Suominen
T. Rantanen
M. Venermo
J. Saarinen
J. Salenius
Author Affiliation
Department of Surgery, Division of Vascular Surgery, Tampere University Hospital, Tampere, Finland. velipekka.suominen@pshp.fi
Source
Eur J Vasc Endovasc Surg. 2008 Jun;35(6):709-14
Date
Jun-2008
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Aged, 80 and over
Ankle - blood supply
Blood pressure
Brachial Artery - physiopathology
Coronary Disease - complications - physiopathology
Extremities - blood supply
Female
Finland - epidemiology
Humans
Ischemia - complications - physiopathology
Kidney Failure, Chronic - complications - physiopathology
Male
Middle Aged
Odds Ratio
Outpatient Clinics, Hospital
Peripheral Vascular Diseases - epidemiology - etiology - physiopathology
Photoplethysmography
Predictive value of tests
Prevalence
Referral and Consultation
Retrospective Studies
Risk assessment
Risk factors
Sensitivity and specificity
Smoking - adverse effects
Abstract
To assess the prevalence and clinical significance of elevated ankle-brachial index (ABI) in patients referred to vascular consultation.
Retrospective clinical study.
In 1,762 patients referred with a suspicion of peripheral arterial disease (PAD), ABI and toe brachial index (TBI) were measured by photoplethysmography. ABI>/=1.3 was considered falsely elevated and TBI/=1.3) in recognizing PAD is good, whereas the sensitivity is only satisfactory.
PubMed ID
18313338 View in PubMed
Less detail

Decreasing the delay to carotid endarterectomy in symptomatic patients with carotid stenosis--outcome of an intervention.

https://arctichealth.org/en/permalink/ahliterature122167
Source
Eur J Vasc Endovasc Surg. 2012 Sep;44(3):261-6
Publication Type
Article
Date
Sep-2012
Author
K. Noronen
P. Vikatmaa
T. Sairanen
M. Lepäntalo
M. Venermo
Author Affiliation
Department of Vascular Surgery, Helsinki University Central Hospital, P.O. Box 340, 00029 HUS, Helsinki, Finland. katariina.noronen@hus.fi
Source
Eur J Vasc Endovasc Surg. 2012 Sep;44(3):261-6
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Aged
Carotid Stenosis - complications - surgery
Chi-Square Distribution
Delivery of Health Care - statistics & numerical data
Endarterectomy, Carotid - adverse effects - statistics & numerical data
Female
Finland
Guideline Adherence - statistics & numerical data
Hospitals, University - statistics & numerical data
Humans
Male
Outcome and Process Assessment (Health Care) - statistics & numerical data
Physician's Practice Patterns - statistics & numerical data
Practice Guidelines as Topic
Preventive Health Services - statistics & numerical data
Program Evaluation
Retrospective Studies
Risk assessment
Risk factors
Stroke - etiology - prevention & control
Time Factors
Treatment Outcome
Waiting Lists
Abstract
Surgical treatment of carotid stenosis after the onset of ischaemic symptoms should be performed within 2 weeks. This aim was accomplished only in 11% during the years 2007-2008 in the Helsinki University Central Hospital (HUCH) region. Since then, special efforts have been made in order to shorten the delay. The aim of this study was to find out how these changes affected the symptom-to-knife time (SKT).
All symptomatic patients (n = 144) who had carotid endarterectomy (CEA, n = 145) in HUCH in 2010 were retrospectively analysed and the SKT was determined.
Of the operations, 37% (n = 53) were performed within the recommended 2 weeks. The median SKT was 19 days (1-183). Of the patients who came to HUCH on an emergency basis (n = 80), 55% (n = 45) were operated within 2 weeks and their median SKT was 13 days (1-148).
The changes that were made in 2008-2009 have significantly shortened the delay in the treatment of carotid stenosis, but the desired time frame of 2 weeks was reached far too seldom. The greatest benefit from preventive CEA is achieved when patients are referred emergently to a clinic where neurologist, imaging resources and vascular surgeon are available.
PubMed ID
22841357 View in PubMed
Less detail

Population-based study of ruptured abdominal aortic aneurysm.

https://arctichealth.org/en/permalink/ahliterature281510
Source
Br J Surg. 2016 Nov;103(12):1634-1639
Publication Type
Article
Date
Nov-2016
Author
M T Laine
S J Laukontaus
I. Kantonen
M. Venermo
Source
Br J Surg. 2016 Nov;103(12):1634-1639
Date
Nov-2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal - mortality
Aortic Rupture - mortality
Female
Finland - epidemiology
Hospital Mortality
Humans
Incidence
Male
Middle Aged
Prognosis
Retrospective Studies
Abstract
The incidence of abdominal aortic aneurysms (AAAs) and their rupture has been reported to be decreasing. The aim was to evaluate trends in ruptured AAA (rAAA) incidence in the hospital district of Helsinki and Uusimaa (HUS) in southern Finland. This was a population-based retrospective review of all patients with rAAA in this well defined geographical area during 2003-2013.
Data for all patients treated for rAAA at Helsinki University Hospital, the only vascular surgery centre in an area of 1·5 million inhabitants, were collected from local vascular registry. All deaths attributed to rAAA were obtained from the cause of death registry of Statistics Finland.
The mean(s.d.) age of the 712 patients with rAAA was 76·5(9·6) years; 76·7 per cent of them were men. Only 330 patients (46·3 per cent of those with rAAA) arrived alive at Helsinki University Hospital. The turn-down rate for surgical treatment was 10·3 per cent. Of the 296 patients operated on, 199 (67·2 per cent) were alive at 30 days. Only 27·9 per cent of all patients were alive 30 days after rupture of the AAA. The incidence of rAAA was 4·3 per 100 000 inhabitants and the mortality rate was 3·2 per 100 000 inhabitants. A decreasing trend was seen in incidence and mortality during the 11-year study interval.
The incidence of rAAA is decreasing in the HUS district. Mortality from rAAA remains very high, because half of the patients die before reaching the hospital.
PubMed ID
27508946 View in PubMed
Less detail

19 records – page 1 of 2.