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Titolo:
Audit and recurrence rates after hernia surgery
Autore:
Sandblom, G; Gruber, G; Kald, A; Nilsson, E;
Indirizzi:
Motala Hosp, Dept Surg, SE-59185 Motala, Sweden Motala Hosp Motala Sweden SE-59185 p, Dept Surg, SE-59185 Motala, Sweden Linkoping Univ Hosp, Dept Surg, S-58185 Linkoping, Sweden Linkoping Univ Hosp Linkoping Sweden S-58185 , S-58185 Linkoping, Sweden
Titolo Testata:
EUROPEAN JOURNAL OF SURGERY
fascicolo: 2, volume: 166, anno: 2000,
pagine: 154 - 158
SICI:
1102-4151(200002)166:2<154:AARRAH>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
RANDOMIZED CONTROLLED TRIAL; INGUINAL-HERNIA; FOLLOW-UP; REPAIR; HERNIORRHAPHY;
Keywords:
inguinal hernia; femoral hernia; registries; questionnaire; quality assurance; medical audit; length of stay; reoperation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Sandblom, G Motala Hosp, Dept Surg, SE-59185 Motala, Sweden Motala Hosp Motala Sweden SE-59185 , SE-59185 Motala, Sweden
Citazione:
G. Sandblom et al., "Audit and recurrence rates after hernia surgery", EURO J SURG, 166(2), 2000, pp. 154-158

Abstract

Objective: To study the effect of quality assurance on the recurrence rateafter hernia repair. Design: A prospective longitudinal cohort study. Setting: District hospital, Sweden. Subjects: All (tr = 1232) patients aged 15-80 years operated upon for inguinal or femoral hernia in Motala 1984, 1986-1988, 1990, and 1992-1994. Intervention: A questionnaire enquiring about pain or a lump in the operated area was sent 3-6 years postoperatively to all patients, excluding thosewho had already been operated on for recurrence and those who had died. Selected cases were examined depending on the answers to the questionnaire. Main outcome measures: Recurrence rate estimated by adding already confirmed recurrences to those found at the clinical examination; reoperation for recurrence; hospital stay; and number of day cases. Cumulative incidence ofreoperation was analysed by actuarial analysis of all patients operated onfrom 1986-1997. Results: The recurrence rate decreased from 18% in 1984 and 1986 to 3% in 1993 and 1994. The reoperation rate for recurrence at three years was 10.8%(95% confidence interval, CI: 9.3 to 12.2%). 3.6% (2.6 to 4.4%) and 2.2% (1.7 to 2.7%) for patients operated on between 1986-1988, 1989-1991 and 1992-1997, respectively. Differences between the first and the second and between the first and the third period were both highly significant (p < 0.001) whereas the difference between the second and third period was not (p = 0.09). Mean hospital stay decreased from 3.5 days in 1984 to 0.9 days in 1994. Conclusion: By recording recurrence rate or its surrogate endpoint, reoperation rate for recurrence, or both, hospital stay, and number of day cases,and presenting these results to participating surgeons, we provided incentives to improve outcome. This has resulted in a rapid decrease in recurrence rate and a shortened hospital stay, thereby improving cost-effectiveness.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 14/07/20 alle ore 13:14:16