We analyze the results of 4 1/2 years of prospective registration of accidents to cyclists. 252 injured were treated at our hospital some as in-patients, some as out-patients. About 30% of all traffic injuries relate to cyclists. The true amount of these injuries is more than ten times the figure in the Norwegian official statistics. Most injuries occur in childhood and early adolescence, because these groups cycle most. Head injuries, wounds and fractures dominate. Two out of three of the injured are males. Accidents involving motor vehicles are more serious than other types of accidents and constitute about 17% of all injuries to cyclists. A lot of helmets have been sold, but no reduction in head injuries has been observed. The classical spoke injuries continue.
Postoperative secondary displacement of displaced femoral neck fractures is a major problem in the treatment of this fracture. In a study of 232 femoral neck fractures operated at the Department of Surgery, Harstad Hospital and at the Departments of Surgery and Orthopaedics, Tromsø University Hospital, the reduction was lost in 12% of the displaced fractures within three months. The fractures were fixated with two 6 mm screws (Olmed). The deep infection rate was 3.4%. There were significant differences between the hospitals. The rate of redisplacement was 5% at Harstad Hospital and 29% at the Tromsø University Hospital (p less than 0.001), the rate of deep infection was 1.8% versus 7.5% (p less than 0.05). Early complications are caused by poor quality of reduction and incorrect positioning of the screws. The surgeons' lack of experience in treating these fractures gives rise to a high rate of complications. The main reason for the low rate of complications in the material from Harstad Hospital is continuous and prospective quality control of femoral neck fractures. Such continuous feedback, and an interest intreating these fractures among the surgical staff, obviously improves the results. When the Olmed method of fixation is used correctly the rate of early complications is small.
In a quasi-experimental study, hospital-treated traffic accident injuries were recorded prospectively for 7 1/2 years in the two Norwegian cities, Harstad and Trondheim. In Harstad the recorded data were used actively in analysis, planning, and implementation of a community-based injury prevention program. Trondheim was the nonequivalent control city. The intervention was divided into three periods, each of 30 months duration. Preventive efforts were implemented to some extent in period 1, increasingly in period 2 and period 3. Traffic safety was promoted in an extensive community program based on the Ottawa charter for health promotion. A 26.6% overall reduction of traffic injury rates was found in Harstad from period 1 to period 3 (p
We studied the incidence of hip fractures in the county of Troms. This was compared with the incidence in a district of the city of Oslo. In both regions, the incidence increased almost exponentially with age both for men and for women. Since 1978, age-adjusted incidence has increased. This is most pronounced for men and for the county of Troms. In 1978 there was a marked difference between Oslo and Troms as regards risk of hip fracture. In 1989 this difference had diminished and persisted only among very old people. Risk factors other than postmenopausal and senile osteoporosis are discussed in an attempt to explain this development.
109 patients were registered in a prospective study of accidents occurring in geriatric nursing homes and treated in Harstad Hospital. In more than 50% the seriousness of the injury was so high that in-patient treatment was necessary. More than 90% of the patients had fallen and 50 patients had suffered fracture of the proximal femur. The incidence of injury is higher than the estimated 13% average, and the seriousness of the injury is substantially higher than the average for all age groups.
There is an increasing demand for high-quality data for the outcome of health care. Diseases of the gastro-intestinal tract involve large patient groups often presenting with serious or life-threatening conditions. Complications may affect treatment outcomes and lead to increased mortality or reduced quality of life. A continuous, risk-adjusted monitoring of major complications is important to improve the quality of health care to patients undergoing gastrointestinal resections. We present the development of the Norwegian Registry for Gastrointestinal Surgery, a national registry for colorectal, upper gastrointestinal, and hepato-pancreato-biliary resections in Norway.
A narrative and qualitative presentation of the development and current state of the registry.
We present the variables and the analysis tools and provide examples for the potential in quality improvement and research. Core characteristics include a strictly limited set of variables to reflect important risk factors, the procedure performed, and the clinical outcomes.
A registry with the potential to present complete national cohort data is a powerful tool for quality improvement and research.
Pathological complete response (ypCR) after neoadjuvant treatment for rectal cancer is associated with favourable survival and a low rate of local recurrence. The aim of the study was to assess the incidence of ypCR among patients with advanced rectal cancer treated with neoadjuvant chemoradiotherapy and curative resection and to explore factors associated with survival.
From 2000 to 2009, 1384 patients enrolled in the national population- based colorectal cancer registry of Norway with advanced T3 and T4 rectal cancer with N0-2, M0 received neoadjuvant long-course (chemo)radiation. The duration of follow-up was a median of 5 years.
ypCR was achieved in 147 (10.6%) patients. The estimated 5-year overall survival rate was 87% (confidence interval ± 5.4) among ypCR and 67% among non-ypCR (confidence interval ± 2.7) (P
Between 1982 and 1991, 112 patients were treated for gastric cancer at Harstad Hospital in Northern Norway. Early gastric cancer accounted for 20% of all the adenocarcinomas (110), which is high compared with figures from other western studies. The role of endoscopy for detecting early gastric cancer is discussed. The five year survival rate after radical surgery was found to be significantly higher for patients with early gastric cancer than for patients who underwent curative surgery for either infiltrative or regional cancer. For patients with a tumour that had invaded the regional lymph nodes the five year survival rate was only 10%. This result can be improved by more extended lymph node dissection. The perioperative mortality rate (8%) was usually a result of severe cancer cachexia or underlying cardial disease, and not anastomotic leakage. The results as regards the cure of early gastric cancer are comparable with those described in other studies.