Skip header and navigation

Refine By

8 records – page 1 of 1.

Differential misclassification of exposure in case-crossover studies.

https://arctichealth.org/en/permalink/ahliterature58249
Source
Epidemiology. 2004 Sep;15(5):589-96
Publication Type
Article
Date
Sep-2004
Author
Jette Möller
Anne-Charlotte Hessén-Söderman
Johan Hallqvist
Author Affiliation
Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden. jette.moller@phs.ki.se
Source
Epidemiology. 2004 Sep;15(5):589-96
Date
Sep-2004
Language
English
Publication Type
Article
Keywords
Cross-Over Studies
Humans
Infant
Logistic Models
Meniere's Disease - epidemiology - pathology
Questionnaires
Research Support, Non-U.S. Gov't
Sweden - epidemiology
Abstract
The aim of this study is to examine 2 types of differential misclassification of exposure in case-crossover studies. The first is the outcome-dependent misclassification of exposure, meaning that if an event has occurred, it could affect the reporting of exposure. The second is differential misclassification of exposure as a result of fading memory over time, which arises if the length of the recall period for case and control windows differs. We use empirical data from a case-crossover study of triggers of attacks in Ménière's disease. The study applied the matched-pair interval control window sampling approach. We examined misclassification in relation to 2 different types of exposures: emotional stress and salty food intake. The study covered repeated events reported by the same patients and involved the sampling of many control windows. Because some of these windows were related to case events and some unrelated, we were able to conduct both case-crossover and control-crossover analyses. Although this group of Ménière patients are well aware of their disease, and many of them have definite ideas regarding what triggers attacks, neither outcome-dependent misclassification nor differential misclassification of exposure resulting from fading memory over time seemed to be a major problem.
PubMed ID
15308959 View in PubMed
Less detail

Factors influencing morbidity after paediatric tonsillectomy: a study of 18,712 patients in the National Tonsil Surgery Register in Sweden.

https://arctichealth.org/en/permalink/ahliterature281394
Source
Eur Arch Otorhinolaryngol. 2016 Aug;273(8):2249-56
Publication Type
Article
Date
Aug-2016
Author
Karolina Elinder
Anne-Charlotte Hessén Söderman
Joacim Stalfors
Johan Knutsson
Source
Eur Arch Otorhinolaryngol. 2016 Aug;273(8):2249-56
Date
Aug-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Analgesics - therapeutic use
Analysis of Variance
Anti-Bacterial Agents - therapeutic use
Child
Child, Preschool
Female
Hemostasis, Surgical - methods
Hemostatic Techniques
Humans
Infant
Linear Models
Male
Morbidity
Nasal Obstruction - surgery
Pain - etiology
Pain, Postoperative - therapy
Palatine Tonsil
Patient Readmission - statistics & numerical data
Postoperative Complications
Postoperative Hemorrhage - etiology - surgery
Registries
Surveys and Questionnaires
Sweden
Tonsillectomy - adverse effects - instrumentation - methods
Tonsillitis - surgery
Abstract
The objective of this study was to examine factors affecting morbidity after tonsillectomy in children. Data from the National Tonsil Surgery Register in Sweden on 18,712 patients who underwent tonsillectomy with or without simultaneous adenoidectomy between 1 and 18 years of age were analysed. This register includes data on sex, gender, surgical indication, and the surgical and haemostasis techniques used for each patient, as well as patient-reported outcomes for haemorrhage, analgesic use and antibiotic use. Comparison of patients who underwent surgery for infection versus upper airway obstruction revealed a significant increase in haemorrhage complications in the infection group. However, no significant difference remained after the adjustments for confounders in multivariable regression analysis. Instead, the increased risk among patients who underwent surgery for infection was mainly attributable to the use of bipolar diathermy and increased patient age. Patients who received surgery for infection reported more days of analgesic use, as well as more unplanned contacts with a health care service provider due to pain, compared with those who underwent surgery for upper airway obstruction. These results remained significant in multivariate analysis. The use of bipolar diathermy for haemostasis resulted in an increased risk, while the use of cold steel surgical instruments, a younger patient age and female sex led to a decreased risk. The surgical and haemostasis techniques used are the most important factors that affect morbidity after tonsillectomy in the paediatric age group. The choice of surgical techniques is of utmost importance for decreasing morbidity in these patients.
PubMed ID
27020269 View in PubMed
Less detail

Paradigm shift in Sweden from tonsillectomy to tonsillotomy for children with upper airway obstructive symptoms due to tonsillar hypertrophy.

https://arctichealth.org/en/permalink/ahliterature116550
Source
Eur Arch Otorhinolaryngol. 2013 Sep;270(9):2531-6
Publication Type
Article
Date
Sep-2013
Author
Elisabeth Hultcrantz
Elisabeth Ericsson
Claes Hemlin
Anne-Charlotte Hessén-Söderman
Kristian Roos
Ola Sunnergren
Joacim Stalfors
Author Affiliation
Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. Elisabeth.Hultcrantz@liu.se
Source
Eur Arch Otorhinolaryngol. 2013 Sep;270(9):2531-6
Date
Sep-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Child
Child, Preschool
Cross Infection - epidemiology
Female
Humans
Hypertrophy - complications - physiopathology - surgery
Infant
Male
Pain, Postoperative - epidemiology
Palatine Tonsil - pathology - surgery
Patient satisfaction
Postoperative Hemorrhage - epidemiology
Questionnaires
Registries
Sweden - epidemiology
Tonsillectomy - adverse effects - methods
Treatment Outcome
Abstract
Tonsillotomy (TT) is now used more often than tonsillectomy (TE) for tonsil obstructive symptoms in Sweden. Both TE and TT give high patient satisfaction although TT results in fewer postoperative bleedings and shorter time when analgesics are needed. The objective of this study is to analyze the current prevalence of different tonsil surgery procedures, the rates of early and late bleeding and other complications. Data from the National Tonsil Surgery Register in Sweden were analyzed. Patients 1-15 years operated for symptoms due to tonsil hypertrophy were included. Surgical procedure, technique and bleedings during hospital stay were registered. Thirty days after surgery, unplanned contacts due to bleeding, infection or pain were reported as were symptom relief after 6 months. 24,083 patients were registered. Of the 10,826 children 1-15 years operated for obstructive symptoms, 64 % were TT or TT+A, and 34 % TE, TE+A. 69 % answered the 30-day questionnaire and 50 % the 6 months. Bleeding in hospital occurred in 1.38 %, late bleedings in 2.06 %: 3.7 % after TE+A, 0.8 % after TT+A. Differences in readmissions due to bleeding, number of days using analgesics, health care contacts due to pain and nosocomial infections were significant between TT and TE, but not differences with regard to symptom relief after 6 months.
PubMed ID
23385384 View in PubMed
Less detail

Radiofrequency tonsillotomy in Sweden 2009-2012.

https://arctichealth.org/en/permalink/ahliterature259517
Source
Eur Arch Otorhinolaryngol. 2014 Jun;271(6):1823-7
Publication Type
Article
Date
Jun-2014
Author
Ola Sunnergren
Claes Hemlin
Elisabeth Ericsson
Anne-Charlotte Hessén-Söderman
Elisabeth Hultcrantz
Erik Odhagen
Joacim Stalfors
Source
Eur Arch Otorhinolaryngol. 2014 Jun;271(6):1823-7
Date
Jun-2014
Language
English
Publication Type
Article
Keywords
Ablation Techniques - instrumentation - methods
Adolescent
Catheter Ablation - instrumentation - methods
Child
Child, Preschool
Cohort Studies
Female
Humans
Hyperplasia - surgery
Male
Pain, Postoperative
Palatine Tonsil - pathology - surgery
Postoperative Complications
Postoperative Hemorrhage
Registries
Retrospective Studies
Sweden
Tonsillectomy - instrumentation - methods
Abstract
The Swedish National Registry for Tonsil Surgery has been operational since 1997. All ENT clinics in Sweden are encouraged to submit data for all patients scheduled for tonsil surgery. Preoperatively, age, gender and indication are recorded. Postoperatively, method (tonsillectomy or tonsillotomy), technique, and perioperative complications are recorded. Postoperative bleedings, pain, infections, and symptom relief are assessed through questionnaires. An earlier report from this registry showed that tonsillotomy had become more common than tonsillectomy in children with tonsil-related upper airway obstruction. The aim of this study was to categorize which instruments were used for tonsillotomy in Sweden and to compare their outcome and complication rate. All children 2-18 years, reported to the registry from March 2009 until September 2012, who underwent tonsillotomy on the indication upper airway obstruction, were included in the study. 1,676 patients were identified. In 1,602 cases (96%), a radiofrequency instrument was used. The postoperative bleeding rate was low (1.2%) and the degree of symptom relief was high (95.1%). Three different radiofrequency instruments (ArthroCare Coblation(®), Ellman Surgitron(®), and Sutter CURIS(®)) were used in 96% of the patients. There were no significant differences in the number of postoperative bleedings, postoperative infections or symptom relief between the instruments. The only difference found was in the number of days on analgesics, where more days were registered after use of Coblation(®). In Sweden, radiofrequency tonsillotomy is the dominant surgical technique used for tonsil hypertrophy causing upper airway obstruction in children. There are no significant differences in outcome between the different radiofrequency instruments except for number of days on analgesics after surgery.
PubMed ID
24366615 View in PubMed
Less detail

Reduced risk of primary postoperative hemorrhage after tonsil surgery in Sweden: results from the National Tonsil Surgery Register in Sweden covering more than 10 years and 54,696 operations.

https://arctichealth.org/en/permalink/ahliterature130532
Source
Laryngoscope. 2011 Nov;121(11):2322-6
Publication Type
Article
Date
Nov-2011
Author
Anne-Charlotte Hessén Söderman
Elisabeth Ericsson
Claes Hemlin
Elisabeth Hultcrantz
Ingemar Månsson
Kristian Roos
Joacim Stalfors
Author Affiliation
Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden. anne-charlotte.hessen-soderman@karolinska.se
Source
Laryngoscope. 2011 Nov;121(11):2322-6
Date
Nov-2011
Language
English
Publication Type
Article
Keywords
Adenoidectomy - statistics & numerical data
Adolescent
Adult
Aged
Aged, 80 and over
Ambulatory Surgical Procedures - statistics & numerical data
Child
Child, Preschool
Cross-Sectional Studies
Female
Humans
Infant
Male
Middle Aged
Palatine Tonsil - surgery
Postoperative Hemorrhage - epidemiology - etiology - prevention & control
Quality Indicators, Health Care - statistics & numerical data
Registries
Risk factors
Sweden
Tonsillectomy - statistics & numerical data
Young Adult
Abstract
To analyze the incidence of primary bleeding following tonsil surgery and to evaluate risk factors.
Register study of the results from the National Tonsil Surgery Register in Sweden covering the period 1997 to 2008 and 54,696 operations.
Data were collected by means of three questionnaires, two filled in by professionals and one 6 months postoperatively by the patient/parent.
A total of 719 patients experienced primary postoperative bleeding during the hospital stay (1.3%). A number of independent factors were correlated with decreased risk of post-tonsillectomy hemorrhage: younger age (P
PubMed ID
21994191 View in PubMed
Less detail

Reducing post-tonsillectomy haemorrhage rates through a quality improvement project using a Swedish National quality register: a case study.

https://arctichealth.org/en/permalink/ahliterature295272
Source
Eur Arch Otorhinolaryngol. 2018 Jun; 275(6):1631-1639
Publication Type
Journal Article
Date
Jun-2018
Author
Erik Odhagen
Ola Sunnergren
Anne-Charlotte Hessén Söderman
Johan Thor
Joacim Stalfors
Author Affiliation
Department of Otorhinolaryngology, Södra Älvsborgs Hospital, Brämhultsvägen 53, 501 82, Borås, Sweden. erik.odhagen@vgregion.se.
Source
Eur Arch Otorhinolaryngol. 2018 Jun; 275(6):1631-1639
Date
Jun-2018
Language
English
Publication Type
Journal Article
Keywords
Child
Female
Humans
Incidence
Male
Palatine Tonsil - surgery
Postoperative Hemorrhage - epidemiology - prevention & control
Quality Improvement
Sweden - epidemiology
Tonsillectomy - adverse effects - methods
Abstract
Tonsillectomy (TE) is one of the most frequently performed ENT surgical procedures. Post-tonsillectomy haemorrhage (PTH) is a potentially life-threatening complication of TE. The National Tonsil Surgery Register in Sweden (NTSRS) has revealed wide variations in PTH rates among Swedish ENT centres. In 2013, the steering committee of the NTSRS, therefore, initiated a quality improvement project (QIP) to decrease the PTH incidence. The aim of the present study was to describe and evaluate the multicentre QIP initiated to decrease PTH rates.
Six ENT centres, all with PTH rates above the Swedish average, participated in the 7-month quality improvement project. Each centre developed improvement plans describing the intended changes in clinical practice. The project's primary outcome variable was the PTH rate. Process indicators, such as surgical technique, were also documented. Data from the QIP centres were compared with a control group of 15 surgical centres in Sweden with similarly high PTH rates. Data from both groups for the 12 months prior to the start of the QIP were compared with data for the 12 months after the QIP.
The QIP centres reduced the PTH rate from 12.7 to 7.1% from pre-QIP to follow-up; in the control group, the PTH rate remained unchanged. The QIP centres also exhibited positive changes in related key process indicators, i.e., increasing the use of cold techniques for dissection and haemostasis.
The rates of PTH can be reduced with a QIP. A national quality register can be used not only to identify areas for improvement but also to evaluate the impact of subsequent improvement efforts and thereby guide professional development and enhance patient outcomes.
Notes
Cites: Clin Otolaryngol. 2007 Oct;32(5):366-71 PMID 17883557
Cites: Eur Arch Otorhinolaryngol. 2015 Mar;272(3):737-43 PMID 25274044
Cites: Int J Otolaryngol. 2015;2015:747403 PMID 26693228
Cites: BMJ Qual Saf. 2012 Jan;21(1):13-20 PMID 21835762
Cites: BMJ Qual Saf. 2014 Apr;23(4):290-8 PMID 24025320
Cites: Eur Arch Otorhinolaryngol. 2015 Dec;272(12):3769-77 PMID 25502742
Cites: BMJ Open. 2017 Jan 13;7(1):e013346 PMID 28087550
Cites: Laryngoscope. 2011 Feb;121(2):279-88 PMID 21271574
Cites: Eur Arch Otorhinolaryngol. 2016 Aug;273(8):2249-56 PMID 27020269
Cites: Laryngorhinootologie. 2016 Apr;95 Suppl 1:S88-S109 PMID 27128406
Cites: J Laryngol Otol. 2014 Feb;128(2):163-5 PMID 24495415
Cites: Circ Cardiovasc Qual Outcomes. 2009 Sep;2(5):458-64 PMID 20031877
Cites: Laryngoscope. 2011 Dec;121(12):2553-60 PMID 22109752
Cites: Acta Anaesthesiol Scand. 2012 Mar;56(3):323-31 PMID 22335277
Cites: BMJ Qual Saf. 2011 Apr;20 Suppl 1:i30-5 PMID 21450767
Cites: Acta Otolaryngol. 2017 Oct;137(10 ):1096-1103 PMID 28598766
Cites: Eur Arch Otorhinolaryngol. 2011 Dec;268(12):1803-7 PMID 21373896
Cites: Clin Otolaryngol. 2015 Jun;40(3):248-54 PMID 25515059
Cites: Laryngoscope. 2013 Oct;123(10):2544-53 PMID 23595509
Cites: Otolaryngol Head Neck Surg. 2018 Jan;158(1):167-176 PMID 28828912
Cites: Lancet. 2004 Aug 21-27;364(9435):697-702 PMID 15325834
Cites: PLoS One. 2014 May 27;9(5):e97875 PMID 24867418
PubMed ID
29574597 View in PubMed
Less detail

Risk of reoperation after tonsillotomy versus tonsillectomy: a population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature280468
Source
Eur Arch Otorhinolaryngol. 2016 Oct;273(10):3263-8
Publication Type
Article
Date
Oct-2016
Author
Erik Odhagen
Ola Sunnergren
Claes Hemlin
Anne-Charlotte Hessén Söderman
Elisabeth Ericsson
Joacim Stalfors
Source
Eur Arch Otorhinolaryngol. 2016 Oct;273(10):3263-8
Date
Oct-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Airway Obstruction - diagnosis - etiology - surgery
Child
Child, Preschool
Female
Humans
Male
Palatine Tonsil - growth & development - surgery
Postoperative Complications - diagnosis - surgery
Reoperation - statistics & numerical data
Retrospective Studies
Risk assessment
Risk factors
Secondary Prevention - methods
Sweden
Tonsillectomy - adverse effects - methods - statistics & numerical data
Abstract
Tonsil surgery to address upper airway obstruction in children can be performed either as a tonsillectomy (TE) or as a tonsillotomy/intracapsular/partial tonsillectomy (TT). The advantage of TT is a decreased risk of postoperative morbidity. The disadvantage is the risk of tonsil regrowth with recurrence of symptoms and/or problems with future tonsil infections, which may demand a reoperation of the tonsils. The aim of this study is to compare the risk of reoperation of the tonsils following TE and TT in children with tonsil-related upper airway obstruction. This is a retrospective register-based cohort study of the Swedish National Patient Register. All children aged 1-12 years who underwent TE or TT from 2007 to 2012 for the main indication of upper airway obstruction were included in the study. The unique Personal Identity numbers were used to follow patients over time in the register and identify additional tonsil surgery. A total of 27,535 patients were included in the study, contributing 76,054 person-years of follow-up. A total of 684 patients (2.5 %) underwent a second tonsil surgery during follow-up. The incidences of reoperation were 1.94 per 1000 person-years in the TE group and 16.34 per 1000 person-years in the TT group. The risk for reoperation was seven times higher (HR 7.16) after TT compared to TE. Younger age was significantly associated with reoperation for both TE and TT and the difference in risk between TE and TT gradually decreased with time. The most common indication for reoperation after both TE and TT was "Upper airway obstruction".
PubMed ID
26728487 View in PubMed
Less detail

Tonsil surgery efficiently relieves symptoms: analysis of 54 696 patients in the National Tonsil Surgery Register in Sweden.

https://arctichealth.org/en/permalink/ahliterature128094
Source
Acta Otolaryngol. 2012 May;132(5):533-9
Publication Type
Article
Date
May-2012
Author
Joacim Stalfors
Elisabeth Ericsson
Claes Hemlin
Elisabeth Hultcrantz
Ingemar Månsson
Kristian Roos
Anne-Charlotte Hessén Söderman
Author Affiliation
Departments of Otorhinolaryngology at Sahlgrenska University Hospital, Gothenburg, Sweden. joacim.stalfors@vgregion.se
Source
Acta Otolaryngol. 2012 May;132(5):533-9
Date
May-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Airway Obstruction - epidemiology - etiology - surgery
Child
Female
Follow-Up Studies
Humans
Incidence
Male
Prospective Studies
Questionnaires
Recurrence
Registries
Sweden - epidemiology
Time Factors
Tonsillectomy - methods - utilization
Tonsillitis - complications - epidemiology - surgery
Treatment Outcome
Young Adult
Abstract
Patients operated with tonsillar surgery report a high degree of symptom relief 6 months after surgery.
The purpose of this study was to analyze symptom relief 6 months after tonsil surgery in relation to age, indication, surgical procedure, primary bleeding and unplanned postoperative visits. The National Tonsil Surgery Register in Sweden offers data from 54,696 patients registered during 1997-2008.
This was a prospective assessment by questionnaire. Data were collected using three questionnaires, two completed by professionals and one 6 months postoperatively by the parents/patients.
Among 54,696 patients, the most common surgical indications were obstruction (49.7%), followed by recurrent tonsillitis (35.2%). Symptom relief 6 months after surgery was high in all indication groups (>92%), and highest for patients operated on the indication peritonsillitis (>98%). The indications obstruction, recurrent tonsillitis or chronic tonsillitis reported a high degree (>96%) of symptom relief. Of the patients who underwent tonsillectomy with adenoidectomy, 97.5% were symptom-free compared to 96% of patients who had tonsillectomy alone and 96.1% who underwent tonsillotomy (p
PubMed ID
22235871 View in PubMed
Less detail

8 records – page 1 of 1.