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12 records – page 1 of 2.

Causes of death after surgery for colon cancer-impact of other diseases, urgent admittance, and gender.

https://arctichealth.org/en/permalink/ahliterature107903
Source
Scand J Gastroenterol. 2013 Oct;48(10):1160-5
Publication Type
Article
Date
Oct-2013
Author
Rune Sjödahl
Johan Rosell
Hans Starkhammar
Author Affiliation
Regional Cancer Center Southeast , SE-581 85 Linköping , Sweden.
Source
Scand J Gastroenterol. 2013 Oct;48(10):1160-5
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cause of Death
Colonic Neoplasms - mortality - pathology - surgery
Comorbidity
Emergencies
Female
Follow-Up Studies
Humans
Male
Middle Aged
Neoplasm Staging
Retrospective Studies
Risk factors
Sex Factors
Surgical Procedures, Elective - mortality
Survival Rate
Sweden - epidemiology
Treatment Outcome
Abstract
OBJECTIVE. In patients with colon cancer, high age and comorbidity is common. In this population-based retrospective study we have investigated causes of death and the influence of urgent operation, and gender on survival. MATERIAL AND METHODS. Medical records of 413 patients with verified colon cancer were reviewed. The diagnosis was made during 2000-2006 and operation was performed in 385 patients (93%). RESULTS. The overall 5-year survival after surgery was 48.3%. At the end of the follow-up, 128 patients (54.9%) had verified colon cancer when they died but 105 patients (45.1%) had no signs of colon cancer. Their 5-year survival was 5.5% and 41.9%, respectively (p
PubMed ID
23964717 View in PubMed
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Defunctioning stoma reduces symptomatic anastomotic leakage after low anterior resection of the rectum for cancer: a randomized multicenter trial.

https://arctichealth.org/en/permalink/ahliterature162152
Source
Ann Surg. 2007 Aug;246(2):207-14
Publication Type
Article
Date
Aug-2007
Author
Peter Matthiessen
Olof Hallböök
Jörgen Rutegård
Göran Simert
Rune Sjödahl
Author Affiliation
Department of Surgery, Orebro University Hospital, Orebro, Sweden. peter.matthiessen@orebroll.se
Source
Ann Surg. 2007 Aug;246(2):207-14
Date
Aug-2007
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Anastomosis, Surgical
Carcinoma - mortality - pathology - surgery
Child
Child, Preschool
Colectomy - methods
Colon, Sigmoid - surgery
Colostomy
Female
Humans
Length of Stay - trends
Male
Middle Aged
Neoplasm Staging
Rectal Neoplasms - mortality - pathology - surgery
Rectum - surgery
Reoperation
Sigmoidoscopy
Survival Rate - trends
Suture Techniques - adverse effects
Sweden - epidemiology
Treatment Failure
Abstract
The aim of this randomized multicenter trial was to assess the rate of symptomatic anastomotic leakage in patients operated on with low anterior resection for rectal cancer and who were intraoperatively randomized to a defunctioning stoma or not.
The introduction of total mesorectal excision surgery as the surgical technique of choice for carcinoma in the lower and mid rectum has led to decreased local recurrence and improved oncological results. Despite these advances, perioperative morbidity remains a major issue, and the most feared complication is symptomatic anastomotic leakage. The role of the defunctioning stoma in regard to anastomotic leakage is controversial and has not been assessed in any randomized trial of sufficient size.
From December 1999 to June 2005, a total of 234 patients were randomized to a defunctioning loop stoma or no loop stoma. Loop ileostomy or loop transverse colostomy was at the choice of the surgeon. Inclusion criteria for randomization were expected survival >6 months, informed consent, anastomosis
Notes
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Comment In: Ann Surg. 2008 Apr;247(4):718-9; author reply 719-2018362645
PubMed ID
17667498 View in PubMed
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[High frequency of postoperative complications. Among patients with hospital stay of at least 5 days almost every third i affected].

https://arctichealth.org/en/permalink/ahliterature99920
Source
Lakartidningen. 2010 Oct 27-Nov 2;107(43):2636-9
Publication Type
Article

Incidence and potential risk factors for hospital-acquired pneumonia in an emergency department of surgery.

https://arctichealth.org/en/permalink/ahliterature287506
Source
Int J Qual Health Care. 2017 Apr 01;29(2):290-294
Publication Type
Article
Date
Apr-01-2017
Author
Marie Stenlund
Rune Sjödahl
R N Pia Yngman-Uhlin
Source
Int J Qual Health Care. 2017 Apr 01;29(2):290-294
Date
Apr-01-2017
Language
English
Publication Type
Article
Keywords
Abdomen, Acute - surgery
Aged
Aged, 80 and over
Case-Control Studies
Cross Infection - epidemiology
Female
Hospitals, University
Humans
Iatrogenic Disease - epidemiology
Incidence
Male
Middle Aged
Pneumonia - epidemiology
Postoperative Complications - epidemiology
Retrospective Studies
Risk factors
Sweden - epidemiology
Wounds and Injuries - surgery
Abstract
Hospital-acquired pneumonia (HAP) is associated with high mortality and is the second most common nosocomial infection. The aim of this study was to calculate the incidence and to identify potential risk factors for HAP in an emergency ward for surgical patients admitted because of acute abdomen or trauma.
A structured review of medical records was conducted. Patients diagnosed with pneumonia >48 h after admittance, were compared with a randomly chosen age-matched reference group. Ten variables judged as potential risk factors for HAP were studied in 90 patients.
An emergency ward for surgical patients with acute abdomen or trauma at an Univerity hospital in Sweden.
A total of 90 patients with HAP and 120 age-matched controls were included.
Risk factors for HAP in patients at a surgical clinic.
Of a total of 10 335 admitted patients, during 4.5 years the hospital stay was longer than 48 h in 4961 patients. Of these 90 (1.8%) fulfilled the strict criteria for HAP. Potential risk factors were suspected or verified aspiration (odds ratio (OR): 23.9) that was 2-fold higher than immobilization (OR: 11.2). Further, chronic pulmonary obstructive disease (COPD)/asthma, abdominal surgery and gastric retention/vomiting were risk factors for HAP.
Verified or suspected aspiration was the dominating risk factor for HAP but also immobilization was frequently associated with HAP. Various established preventive measures should be implemented in the nursing care to reduce the frequency of HAP.
PubMed ID
28339769 View in PubMed
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Learning From Incident Reporting? Analysis of Incidents Resulting in Patient Injuries in a Web-Based System in Swedish Health Care.

https://arctichealth.org/en/permalink/ahliterature309781
Source
J Patient Saf. 2020 12; 16(4):264-268
Publication Type
Journal Article
Date
12-2020
Author
Eva-Lena Ahlberg
Johan Elfström
Madeleine Risberg Borgstedt
Annica Öhrn
Christer Andersson
Rune Sjödahl
Per Nilsen
Author Affiliation
From the Center for Healthcare Development, County Council of Östergötland.
Source
J Patient Saf. 2020 12; 16(4):264-268
Date
12-2020
Language
English
Publication Type
Journal Article
Keywords
Humans
Learning Health System - methods
Patient Safety - standards
Risk Management - methods
Sweden
Abstract
Incident reporting (IR) systems have the potential to improve patient safety if they enable learning from the reported risks and incidents. The aim of this study was to investigate incidents registered in an IR system in a Swedish county council.
The study was conducted in the County Council of Östergötland, Sweden. Data were retrieved from the IR system, which included 4755 incidents occurring in somatic care that resulted in patient injuries from 2004 to 2012. One hundred correctly classified patient injuries were randomly sampled from 3 injury severity levels: injuries leading to deaths, permanent harm, and temporary harm. Three aspects were analyzed: handling of the incident, causes of the incident, and actions taken to prevent its recurrence.
Of the 300 injuries, 79% were handled in the departments where they occurred. The department head decided what actions should be taken to prevent recurrence in response to 95% of the injuries. A total of 448 causes were identified for the injuries; problems associated with procedures, routines, and guidelines were most common. Decisions taken for 80% of the injuries could be classified using the IR system documentation and root cause analysis. The most commonly pursued type of action was change of work routine or guideline.
The handling, causes, and actions taken to prevent recurrence were similar for injuries of different severity levels. Various forms of feedback (information, education, and dialogue) were an integral aspect of the IR system. However, this feedback was primarily intradepartmental and did not yield much organizational learning.
PubMed ID
29112034 View in PubMed
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Obstetric anal sphincter injury ten years after: subjective and objective long term effects.

https://arctichealth.org/en/permalink/ahliterature63267
Source
BJOG. 2005 Mar;112(3):312-6
Publication Type
Article
Date
Mar-2005
Author
Eva Uustal Fornell
Leif Matthiesen
Rune Sjödahl
Göran Berg
Author Affiliation
Department of Molecular and Clinical Medicine, Division of Obstetrics and Gynecology, University Hospital, S-581 85 Linköping, Sweden.
Source
BJOG. 2005 Mar;112(3):312-6
Date
Mar-2005
Language
English
Publication Type
Article
Keywords
Adult
Aged
Anal Canal - injuries
Case-Control Studies
Comparative Study
Endosonography
Fecal Incontinence - etiology - pathology - physiopathology
Female
Flatulence - etiology - pathology - physiopathology
Follow-Up Studies
Humans
Libido - physiology
Manometry
Middle Aged
Obstetric Labor Complications - pathology - physiopathology
Orgasm - physiology
Perineum - pathology
Pregnancy
Pressure
Rupture
Sexual Dysfunction, Physiological - etiology - pathology - physiopathology
Urinary Incontinence - etiology - pathology - physiopathology
Abstract
OBJECTIVE: To establish the long term effects of obstetric anal sphincter rupture. DESIGN: Prospective observational study. SETTING: University hospital in Sweden. POPULATION: Eighty-two women from a prospective study from 1990 to compare anorectal function after third degree tear. METHODS: Women completed a structured questionnaire, underwent a clinical examination and anorectal manometry, endoanal ultrasound (EAUSG) with perineal body measurement. MAIN OUTCOME MEASURES: Symptoms of anal incontinence, sexual symptoms, anal manometry scores and evidence of sphincter damage on EAUSG. RESULTS: Five women had undergone secondary repair and three were lost to follow up. Fifty-one women (80%) completed the questionnaire. Twenty-six out of 46 (57%) of the original study group and 6/28 (20%) of the original controls were examined. Incontinence to flatus and liquid stool was more severe in the study group than in controls. Flatus incontinence was significantly more pronounced among women with subsequent vaginal deliveries. Mean maximal anal squeeze pressures were 69 mmHg in the partial rupture group and 42 mmHg in the complete rupture group (P= 0.04). Study group women with signs of internal sphincter injury reported more pronounced faecal incontinence and had lower anal resting pressures (24 mmHg) than those with intact internal sphincters (40 mmHg) (P= 0.01). Perineal body thickness of less than 10 mm was associated with incontinence for flatus and liquid stools, less lubrication during sex and lower anal squeeze pressures (58 mmHg vs 89 mmHg, P= 0.04). CONCLUSIONS: Subjective and objective anal function after anal sphincter injury deteriorates further over time and with subsequent vaginal deliveries. Thin perineal body and internal sphincter injury seem to be important for continence and anal pressure.
PubMed ID
15713145 View in PubMed
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Preventable Adverse Events in Surgical Care in Sweden: A Nationwide Review of Patient Notes.

https://arctichealth.org/en/permalink/ahliterature274944
Source
Medicine (Baltimore). 2016 Mar;95(11):e3047
Publication Type
Article
Date
Mar-2016
Author
Lena Nilsson
Madeleine Borgstedt Risberg
Agneta Montgomery
Rune Sjödahl
Kristina Schildmeijer
Hans Rutberg
Source
Medicine (Baltimore). 2016 Mar;95(11):e3047
Date
Mar-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Female
Humans
Iatrogenic Disease - epidemiology
Length of Stay
Male
Middle Aged
Postoperative Complications - epidemiology
Severity of Illness Index
Sweden - epidemiology
Young Adult
Abstract
Adverse events (AEs) occur in health care and may result in harm to patients especially in the field of surgery. Our objective was to analyze AEs in surgical patient care from a nationwide perspective and to analyze the frequency of AEs that may be preventable. In total 19,141 randomly selected admissions in 63 Swedish hospitals were reviewed each month during 2013 using a 2-stage record review method based on the identification of predefined triggers. The subgroup of 3301 surgical admissions was analyzed. All AEs were categorized according to site, type, level of severity, and degree of preventability. We reviewed 3301 patients' records and 507 (15.4%) were associated with AEs. A total of 62.5% of the AEs were considered probably preventable, over half contributed to prolonged hospital care or readmission, and 4.7% to permanent harm or death. Healthcare acquired infections composed of more than one third of AEs. The majority of the most serious AEs composed of healthcare acquired infections and surgical or other invasive AEs. The incidence of AEs was 13% in patients 18 to 64 years old and 17% in =65 years. Pressure sores and drug-related AEs were more common in patients being =65 years. Urinary retention and pressure sores showed the highest degree of preventability. Patients with probably preventable AEs had in median 7.1 days longer hospital stay. We conclude that AEs are common in surgical care and the majority are probably preventable.
Notes
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PubMed ID
26986126 View in PubMed
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[Preventable hospital acquired infections are common].

https://arctichealth.org/en/permalink/ahliterature286278
Source
Lakartidningen. 2017 Apr 04;114
Publication Type
Article
Date
Apr-04-2017
Author
Pernilla Nordqvist
Magnus Roberg
Martin Magnusson
Rune Sjödahl
Source
Lakartidningen. 2017 Apr 04;114
Date
Apr-04-2017
Language
Swedish
Geographic Location
Sweden
Publication Type
Article
Keywords
Catheter-Related Infections - epidemiology
Catheterization, Central Venous - adverse effects
Cross Infection - classification - epidemiology - prevention & control
Hospitals, University - statistics & numerical data
Humans
Medical Records
Surgical Wound Infection - epidemiology
Sweden - epidemiology
Urinary Tract Infections - epidemiology
Abstract
Preventable hospital acquired infections are common A modified GTT (Global trigger tool) was used for 480 patient records from 15 departments at Linköping University Hospital. Sixty-three hospital-acquired infections (HAI) were detected at 59 admissions. Postoperative wound infections were most common (44.4 %). Catheter-related urinary infections occurred in 15.9 %, infections associated with a central venous catheter in 7.9 % and hospital-acquired pneumonia in 6.3 % of all HAI.  Other types of HAI consisting of any abscess or oral Candida infection composed 17.5 %. Some 221 patients were operated (46.0 %). Postoperative wound infections were diagnosed in 28 of them (12.7 %), the majority after discharge from hospital. Most urinary infections were diagnosed in emergency patients (8/10). Prolonged hospital stay or unplanned return to hospital occurred in 54 %. Out of 63 HAI some 76.2 % were judged as probably preventable, and 11.1 % as preventable.
PubMed ID
28375527 View in PubMed
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[Surgical emergency services must be changed to manage recruitment of new personnel].

https://arctichealth.org/en/permalink/ahliterature191253
Source
Lakartidningen. 2002 Jan 24;99(4):311-3
Publication Type
Article
Date
Jan-24-2002

The Swedish Crohn Trial: A Prematurely Terminated Randomized Controlled Trial of Thiopurines or Open Surgery for Primary Treatment of Ileocaecal Crohn's Disease.

https://arctichealth.org/en/permalink/ahliterature276620
Source
J Crohns Colitis. 2016 Jan;10(1):50-4
Publication Type
Article
Date
Jan-2016
Author
Linda Gerdin
Anders S Eriksson
Gunnar Olaison
Rune Sjödahl
Magnus Ström
Johan D Söderholm
Pär Myrelid
Source
J Crohns Colitis. 2016 Jan;10(1):50-4
Date
Jan-2016
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Anastomosis, Surgical - methods
Area Under Curve
Azathioprine - administration & dosage
Budesonide - administration & dosage
Cecum - pathology - surgery
Colectomy - methods
Crohn Disease - diagnosis - drug therapy - surgery
Female
Follow-Up Studies
Humans
Ileum - pathology - surgery
Laparotomy - methods
Male
Middle Aged
Prospective Studies
Risk assessment
Severity of Illness Index
Sex Factors
Statistics, nonparametric
Sweden
Treatment Failure
Treatment Outcome
Young Adult
Abstract
The importance of efficient and safe treatment of Crohn's disease is highlighted by its chronicity. Both medical and surgical treatments have shown good results in the symptomatic control of limited ileocaecal Crohn's disease. The aim of this study was to compare medical treatment with surgical treatment of ileocaecal Crohn's disease.
Thirty-six patients from seven hospitals with primary ileocaecal Crohn's disease were randomized to either medical or surgical treatment. The medical treatment was induction of remission with budesonide and thereafter maintenance treatment with azathioprine. The surgical treatment was open ileocaecal resection. Crohn's disease activity index over time, expressed as area under the curve at 1, 3 and 5 years, was the primary endpoint. Subjective health measured with the 36-item Short Form Survey Instrument (SF36) and a visual analogue scale (VAS) were secondary endpoints.
There were no differences between the treatment groups in Crohn's disease activity index over time. General health, measured as SF36 score, was higher in patients receiving surgical treatment than in those receiving medical treatment at 1 year, but there was no corresponding difference in VAS. Due to the slow inclusion rate and changes in clinical practice, the study was t=erminated prematurely.
The study ended up being underpowered and should be interpreted with caution, but there was no clinically significant difference between the two treatment arms. Further studies are needed to address this important clinical question.
PubMed ID
26507858 View in PubMed
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12 records – page 1 of 2.