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Mickelsson, M., Ekblom, K., Stefansson, K., Liv, P., Själander, A., Näslund, U. & Hultdin, J. (2025). ABO and RhD blood groups as contributors to dyslipidaemia: a cross-sectional study. Lipids in Health and Disease, 24(1), Article ID 18.
Open this publication in new window or tab >>ABO and RhD blood groups as contributors to dyslipidaemia: a cross-sectional study
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2025 (English)In: Lipids in Health and Disease, E-ISSN 1476-511X, Vol. 24, no 1, article id 18Article in journal (Refereed) Published
Abstract [en]

Background: The ABO blood group system has shown an association with cardiovascular disease. The susceptibility to CVD is proposed to be partly mediated by dyslipidaemia in non-O individuals. Previous studies are scarce for the RhD blood group, but we recently showed that RhD − young individuals are associated with subclinical atherosclerosis. Hence, we sought to examine whether the ABO blood groups and RhD factor are associated with dyslipidaemia.

Methods: All participants were part of the VIPVIZA study, including 3532 individuals with available plasma lipid levels. Lipids were assessed as total, LDL, HDL, remnant, non-HDL cholesterol and triglycerides. Information about ABO and RhD was retrieved by linking VIPVIZA with the SCANDAT-3 database, where 85% of VIPVIZA participants were registered.

Results: For the ABO blood groups, no significant differences in lipid levels between non-O and O individuals were seen. In 40-year-old males, RhD − individuals compared to RhD + had higher levels of non-HDL cholesterol, LDL cholesterol, and remnant cholesterol, with ratios of geometric means of 1.21 (CI95% 1.03; 1.43), 1.20 (1.02; 1.41) and 1.38 (1.00; 1.92), respectively. No differences in lipid levels depending on the RhD blood group were seen in women or the older age groups.

Conclusion: Our study indicates that younger RhD − men have increased non-HDL, LDL, and remnant cholesterol levels. Thus, the RhD blood group, but not ABO, seems to be associated with dyslipidaemia and may act as a future possible risk marker of cardiovascular disease.

Keywords
ABO Blood-Group system, Atherosclerosis, Dyslipidaemia, RhD blood group
National Category
Hematology Cardiology and Cardiovascular Disease Public Health, Global Health and Social Medicine
Identifiers
urn:nbn:se:umu:diva-236016 (URN)10.1186/s12944-025-02444-6 (DOI)001404787500003 ()39844181 (PubMedID)2-s2.0-85216608008 (Scopus ID)
Funder
Region Västerbotten, ALFVLL-298001Region Västerbotten, ALFVLL-643391Swedish Research Council, 521–2013-2708Swedish Research Council, 2016–01891Swedish Heart Lung Foundation, 20150369Swedish Heart Lung Foundation, 20170481Visare Norr, 981146Swedish Society of MedicineNorrländska HjärtfondenThe Swedish Stroke Association
Available from: 2025-03-07 Created: 2025-03-07 Last updated: 2025-05-12Bibliographically approved
Johansson, K., Norström, F., Ivarsson, A., Richter Sundberg, L., Själander, A., Therrien, A., . . . Myléus, A. (2025). Early career progression in young adults with coeliac disease: a register‐based retrospective cohort study. Acta Paediatrica
Open this publication in new window or tab >>Early career progression in young adults with coeliac disease: a register‐based retrospective cohort study
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2025 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aim: To investigate early career progression and national insurance use in young adults with paediatric coeliac disease.

Methods: We performed a register study of a population born in Sweden between 1976 and 1992. Coeliac disease was diagnosed before 15 years of age. The comparison population was matched 4:1 by sex, region of residence at birth and birth year/month. We analysed education, employment, income, job position and national insurance use (sickness benefits, parental leave benefits and social welfare provision) at 25 and 30 years of age.

Results: We identified 1812 individuals with coeliac disease (6888 comparison population) at 25 years of age and 263 individuals (984 comparison population) at 30 years of age. No statistically significant differences were seen in education, employment, income, job position, use of parental leave benefits or social welfare provision. More individuals with coeliac disease used sickness benefits at age 25 years (OR 1.34 [95% CI 1.12–1.59]).

Conclusion: In this register study, we showed that coeliac disease diagnosed in childhood does not cause disadvantages on career progression on a population level. However, findings suggest that coeliac disease increases the risk for sickness benefit use.

Place, publisher, year, edition, pages
John Wiley & Sons, 2025
Keywords
career, children, coeliac disease, gluten-free diet, national insurance use
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:umu:diva-237021 (URN)10.1111/apa.70073 (DOI)001455667300001 ()40150956 (PubMedID)2-s2.0-105001636639 (Scopus ID)
Funder
Region Västerbotten
Note

Funding: The Center for Clinical Research Region Dalarna, Anna Cederberg foundation, Faculty of Medicine Umeå University, National Research Schoolin General Practice, Region Västerbotten and the Swedish Celiac Disease Association supported with funding of the project. Research reported in this publication was supported by the National Institute of Diabetes And Digestive And Kidney Diseases of the National Institutes of Health under Award NumberK23DK119584. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes ofHealth. This study was supported by the ISSCD M-in-M programme. The ISSCD M-in-M programme has been made possible by an unrestricted grant fromTakeda Pharmaceuticals. The Umeå SIMSAM Lab data infrastructure used in this study was developed with support from the Swedish Research Council, the Riksbanken Jubileumsfond and by strategic funds from Umeå University. The work was done independent of the funding source.

Available from: 2025-03-30 Created: 2025-03-30 Last updated: 2025-04-28
Mickelsson, M., Ekblom, K., Stefansson, K., Själander, A., Näslund, U. & Hultdin, J. (2025). Exploring the extent of post-analytical errors, with a focus on transcription errors - an intervention within the VIPVIZA study. Clinical Chemistry and Laboratory Medicine
Open this publication in new window or tab >>Exploring the extent of post-analytical errors, with a focus on transcription errors - an intervention within the VIPVIZA study
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2025 (English)In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objectives: We examined the magnitude of transcription errors in lipid variables in the VIPVIZA study and assessed whether education among the research personnel reduced the error frequency at follow-up. We also examined how the errors affected the SCORE2 risk prediction algorithm for cardiovascular disease, which includes lipid parameters, as this could lead to an incorrect treatment decision.

Methods: The VIPVIZA study includes assessment of lipid parameters, where results for total cholesterol, triglycerides, HDL cholesterol, and calculated LDL cholesterol are transcribed into the research database by research nurses. Transcription errors were identified by recalculating LDL cholesterol, and a difference>0.15 indicated a transcription error in any of the four lipid parameters. To assess the presence of risk category misclassification, we compared the individual's SCORE2 risk category based on incorrect lipid levels to the SCORE2 categories based on the correct lipid levels.

Results: The transcription error frequency was 0.55 % in the 2019 VIPVIZA research database and halved after the educational intervention to 0.25 % in 2023. Of the 39 individuals who had a transcription error in total or HDL cholesterol (with the possibility of affecting the SCORE2 risk category based on non-HDL cholesterol), six individuals (15 %) received an incorrect risk category due to the error.

Conclusions: Transcription errors persist despite digitalisation improvements. It is essential to minimise transcriptions in fields outside the laboratory environment, as we observed that critical decisions also rely on accurate information such as the SCORE2-risk algorithm, which is dependent on lab results but not necessarily reported by the laboratory.

Place, publisher, year, edition, pages
Walter de Gruyter, 2025
Keywords
clerical error, laboratory quality assurance, lipid parameters, post-analytical error, SCORE2, transcription error
National Category
Other Clinical Medicine
Identifiers
urn:nbn:se:umu:diva-236668 (URN)10.1515/cclm-2025-0009 (DOI)001434824000001 ()40021473 (PubMedID)2-s2.0-86000145326 (Scopus ID)
Funder
Region Västerbotten, ALFVLL-298001Region Västerbotten, ALFVLL-643391Swedish Research Council, 521- 2013-2Swedish Research Council, 708Swedish Research Council, 2016-01891Swedish Heart Lung Foundation, 20150369Swedish Heart Lung Foundation, 20170481Visare Norr, 981146Swedish Society of MedicineThe Swedish Stroke AssociationSwedish Insurance Society
Available from: 2025-03-25 Created: 2025-03-25 Last updated: 2025-05-12
Wegdell, G. S., Åkerstedt, J., Mukka, S., Själander, A. & Knutsson, B. (2025). Stroke after surgery for lumbar spinal stenosis: a retrospective register-based study. European spine journal
Open this publication in new window or tab >>Stroke after surgery for lumbar spinal stenosis: a retrospective register-based study
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2025 (English)In: European spine journal, ISSN 0940-6719, E-ISSN 1432-0932Article in journal (Refereed) Epub ahead of print
Abstract [en]

PURPOSE: To describe the incidence of stroke in the first year after surgery for lumbar spinal stenosis (LSS).

METHODS: The study included 64,179 Swedish National Spine Register (Swespine) patients who underwent surgery for LSS between 2001 and 2020. The primary outcome was the diagnosis of stroke within the first year after surgery, as documented in the Swedish Stroke Register. The incidence was quantified as the number of strokes per 1,000 surgeries within a defined period, inclusive of the incidence rate (number of strokes/100,000 person-years). An adjusted Cox regression model was used to analyse whether age, sex, smoking, or surgery with implants further increased the risk of stroke.

RESULTS: In the first year after surgery, 426 patients (0.66%) developed a stroke. The risk of stroke was highest during the first 30 days (n=72, 0.11%). Stroke incidence was 1.1/1,000 surgeries during the first 30 days and 6.6/1,000 surgeries during the first year after surgery. The incidence rate during the initial 30 days was 1,394 strokes per 100,000 person-years, while the incidence rate during the first year was 660 strokes per 100,000 person-years. Smoking (hazard ratio [HR], 1.82; 95% confidence interval [CI], 1.31-2.52), age 65-74 years (HR, 2.65; 95% CI, 1.91-3.67), and age ≥75 years (HR, 6.04; 95% CI, 4.42-8.25) further increased the risk of stroke.

CONCLUSION: The incidence of stroke after LSS surgery was the highest during the first 30 days. However, the absolute number of strokes was small. The risk of stroke could be of minor concern for most of the patients even if older age and smoking were identified as risk factors.

Place, publisher, year, edition, pages
Springer Nature, 2025
Keywords
Lumbar spinal stenosis, Riksstroke, Spine surgery, Stroke, Swespine
National Category
Orthopaedics
Identifiers
urn:nbn:se:umu:diva-237310 (URN)10.1007/s00586-025-08819-8 (DOI)001461151300001 ()40192769 (PubMedID)2-s2.0-105002170531 (Scopus ID)
Funder
Region VästernorrlandVisare Norr
Available from: 2025-04-07 Created: 2025-04-07 Last updated: 2025-05-06
Enblom, A., Renlund, H., Andréasson, B., Holmberg, H., Liljeholm, M. & Själander, A. (2025). Thrombosis, major bleeding, and mortality in 1079 patients with myelofibrosis: a matched population-based study. Blood Advances, 9(11), 2783-2793
Open this publication in new window or tab >>Thrombosis, major bleeding, and mortality in 1079 patients with myelofibrosis: a matched population-based study
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2025 (English)In: Blood Advances, ISSN 2473-9529, E-ISSN 2473-9537, Vol. 9, no 11, p. 2783-2793Article in journal (Refereed) Published
Abstract [en]

Bleeding and thrombotic events are known complications in myeloproliferative neoplasms (MPNs), but few studies have exclusively focused on patients with myelofibrosis (MF). In this nationwide population-based study, we assessed the frequency of major bleeding, thrombotic events, and all-cause mortality in 1079 patients diagnosed with MF and 5395 matched controls using multiple Swedish health care registers. Major bleeding, arterial, and venous events were seen at a rate of 2.55, 2.59, and 1.06 events per 100 years, respectively, in patients with MF. Compared to controls, the rates of bleedings, arterial events, venous events, and mortality were increased, with hazard ratios of 3.78 (95% confidence interval [CI], 2.98-4.79; P < .001), 1.73 (95% CI, 1.40-2.12; P < .001), 2.75 (95% CI, 1.93-3.90; P < .001), and 3.92 (95% CI, 3.50-4.40; P < .001), respectively. Patients treated with JAK inhibitors (JAKis) had higher rates of major bleeding (5.33), arterial events (4.67), and venous events (1.56) than patients with no ongoing symptom–directed therapy (rates, 2.32, 2.15, and 0.79) or hydroxyurea (rates, 2.05, 2.35, and 1.27, respectively). The use of JAKis or low-molecular-weight heparin, previous arterial or venous events, and older age were identified as independent risk factors for new arterial or venous events. A previous venous event, higher leukocyte count at diagnosis, and ongoing JAKi treatment were associated with an increased risk of major bleeding. This study shows that patients with MF have higher rates of thromboembolic events and major bleeding than described in other MPNs, and thromboembolic complications and major bleeding diverge in the different treatment groups.

Place, publisher, year, edition, pages
American Society of Hematology, 2025
National Category
Hematology
Identifiers
urn:nbn:se:umu:diva-240094 (URN)10.1182/bloodadvances.2025016247 (DOI)40117492 (PubMedID)2-s2.0-105007210220 (Scopus ID)
Funder
Visare Norr
Available from: 2025-06-12 Created: 2025-06-12 Last updated: 2025-06-12Bibliographically approved
Hultin, M., Själander, A., Werner, M., Hultberg, P., Ragnarsson, O., Skoglund, I., . . . Dahlin, M. (2025). Vägar till svensk legitimation för läkare utbildade i tredje land: [Paths to Swedish medical license for international medical graduates]. Läkartidningen, 122, Article ID 24118.
Open this publication in new window or tab >>Vägar till svensk legitimation för läkare utbildade i tredje land: [Paths to Swedish medical license for international medical graduates]
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2025 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 122, article id 24118Article in journal (Refereed) Published
Abstract [sv]
  • För att få svensk läkarlegitimation ska läkaren kunna utöva läkaryrket på ett patientsäkert sätt.
  • Låga krav på dokumentation av tidigare utbildning för tillträde till kunskapsprovsvägen till svensk legitimation nödvändiggör ett brett kunskaps- och färdighetsprov.
  • Kunskapsprovet har samma målbild för säkerställande av kunskaper och färdigheter som svensk legitimationsgrundande läkarutbildning.
  • Vägen via kompletterande utbildning till svensk legitimation kommer att förändras för att bli direkt legitimationsgrundande.
  • Målbilden för säkerställande av kunskaper och färdigheter vid kompletterande utbildning bör vara densamma som vid svensk legitimationsgrundande läkarutbildning.
Abstract [en]

There are four paths to a Swedish medical license. A shared agreement exists for those converting from a European license to recognize qualifications granted in the respective countries mutually. Swedish medical graduates and International Medical Graduates (IMGs) trained outside the EU/EES/Schweiz are assessed against the professional qualifications specified in the Higher Education Ordinance (1993:100). This paper discusses the different pathways to a Swedish Medical License, how they are interrelated and changing, and the number of licenses granted via the specific pathways in 2023 and the previous 7 years. In 2023, 2,318 Swedish medical licenses were awarded. The largest group (1,407/2,318) were graduates from a Swedish medical school (with a minimum of 18 months of internship (AT)). The second largest group (704/2,318) were licensed physicians from a country within the EU/EEA. The smallest group (207/2,318) were international medical graduates (IMGs) who had passed the proficiency test (with a 6-month internship) or a complementary medical education (KUL) at one of the Swedish universities (with a minimum of 18 months of internship (AT)). During 2016–2023, 826 IMGs passed the proficiency test, and 533 IMGs completed KUL. During the same period, 10,958 students graduated from Swedish medical programmes, and 6,844 medical licenses were approved based on education in the EU/EEC. The pathway for IMGs starts with applying to the National Board of Health and Welfare to be approved for the tests. The theoretical test is a 180-item exam with single-best answers covering the medical field with basic and clinical sciences. After passing the theoretical test, the practical skills are tested with an Objective Structured Clinical Examination (OSCE) with fourteen 6-minute and four 14-minute stations. After passing the practical test, the IMG is assessed during a 6-month internship and must take an online Swedish law course. When successfully passing these steps, the IMG applies for a Swedish medical license with a certificate of passing a language test in Swedish at the C1 level. The educational pathway consists of a 1- to 2-year-long complementary programme for international medical graduates (KUL) offered at five Swedish universities. The regular Swedish medical programmes are in transition from preparing for an internship to preparing to qualify directly for a medical license without an intermediate internship. Consequently, KUL also needs to develop new curricula, preparing for direct qualification for a medical license, from which the first students will most likely graduate in spring 2027. 

Place, publisher, year, edition, pages
Sveriges läkarförbund, 2025
National Category
Other Clinical Medicine
Identifiers
urn:nbn:se:umu:diva-234611 (URN)39876695 (PubMedID)2-s2.0-85217274467 (Scopus ID)
Available from: 2025-01-27 Created: 2025-01-27 Last updated: 2025-02-24Bibliographically approved
Mickelsson, M., Ekblom, K., Stefansson, K., Liv, P., Nyman, E., Själander, A., . . . Hultdin, J. (2024). ABO blood groups, RhD factor and their association with subclinical atherosclerosis assessed by carotid ultrasonography. Journal of Clinical Medicine, 13(5), Article ID 1333.
Open this publication in new window or tab >>ABO blood groups, RhD factor and their association with subclinical atherosclerosis assessed by carotid ultrasonography
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2024 (English)In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 13, no 5, article id 1333Article in journal (Refereed) Published
Abstract [en]

Background: The ABO blood group system has previously been associated with cardiovascular disease (CVD), where non-O blood group individuals have shown an increased risk. Studies assessing early atherosclerotic disease while also including RhD are few. We aimed to determine whether the ABO and RhD blood groups are associated with subclinical atherosclerosis in a healthy population.

Methods: We included 3532 participants from the VIPVIZA trial with available carotid ultrasonography results to assess subclinical disease. Information about blood groups was obtained from the SCANDAT-3 database, where 85% of VIPVIZA participants were registered.

Results: RhD− individuals aged 40 years showed increased carotid intima–media thickness (B 1.09 CI 95% 1.03; 1.14) compared to RhD+ individuals. For ABO, there were no differences in ultrasonography results when assessing the whole study population. However, 60-year-old individuals with heredity for CVD and a non-O blood group had decreased odds for carotid plaques (OR 0.54 CI 95% 0.33; 0.88).

Conclusions: RhD blood group is associated with subclinical atherosclerosis in younger individuals, indicating a role as a mediator in the atherosclerotic process. In addition, a non-O blood group was associated with decreased subclinical atherosclerosis in individuals aged 60 and with heredity (corresponding to the group with the highest atherosclerotic burden).

Place, publisher, year, edition, pages
MDPI, 2024
Keywords
ABO blood group system, atherosclerosis, cardiovascular prevention, carotid intima–media thickness, carotid plaques, RhD factor
National Category
Cardiology and Cardiovascular Disease Hematology
Identifiers
urn:nbn:se:umu:diva-222584 (URN)10.3390/jcm13051333 (DOI)001182882700001 ()2-s2.0-85187443119 (Scopus ID)
Funder
Visare Norr, Dnr 981146Region Västerbotten, ALFVLL-298001Region Västerbotten, AALFVLL-643391Swedish Research Council, 521-2013-2708Swedish Research Council, 2016-01891Swedish Heart Lung Foundation, 20150369Swedish Heart Lung Foundation, 20170481
Available from: 2024-04-08 Created: 2024-04-08 Last updated: 2025-05-12Bibliographically approved
Holmberg, H., Glader, E.-L., Näslund, U., Carlberg, B., Sönnerstam, E., Norberg, M. & Själander, A. (2024). Improved adherence to statin treatment and differences in results between men and women after pictorial risk communication: a sub-study of the VIPVIZA RCT. European Journal of Clinical Pharmacology, 80(8), 1209-1218
Open this publication in new window or tab >>Improved adherence to statin treatment and differences in results between men and women after pictorial risk communication: a sub-study of the VIPVIZA RCT
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2024 (English)In: European Journal of Clinical Pharmacology, ISSN 0031-6970, E-ISSN 1432-1041, Vol. 80, no 8, p. 1209-1218Article in journal (Refereed) Published
Abstract [en]

Background: People with intermediate CVD risk constitute most of the population. Within this group, the proportion of events is lower compared to the high-risk group, but they contribute with the largest absolute number of events. Atherosclerosis is a dynamic process and progression can be slowed or even reversed with medication and lifestyle changes, but adherence to prescribed treatment is crucial.

Aim: To investigate the long-term effects of interventions with pictorial risk communication of cardiovascular (CVD) risk on average adherence in a group of statin users. Compare response in adherence over time between men and women after intervention.

Methods: Participants on active statin treatment were followed up to 5 years after being randomly assigned to an intervention program aimed at raising CVD risk awareness among participants and their physicians. Merging prescribed medication databases with VIPVIZA study to study adherence over time. A moving average adherence was used to compare groups.

Results: Generally, the average adherence to statins among the 512 participants was high. Men had a higher average adherence over time, while women had a sharper increase in adherence in conjuncture with the intervention program.

Conclusions: Both men and women were receptive to pictorial information regarding CVD risk, but the intervention effect was more pronounced in women. Sex differences are important when considering risk communication strategies. Periodically repeating the intervention was beneficial for maintaining the intervention effect over time.

Place, publisher, year, edition, pages
Springer, 2024
Keywords
Atherosclerosis, Cardiovascular disease prevention, Cardiovascular risk, Pictorial information, Statin initiation, Statins
National Category
Public Health, Global Health and Social Medicine Cardiology and Cardiovascular Disease
Identifiers
urn:nbn:se:umu:diva-224129 (URN)10.1007/s00228-024-03694-6 (DOI)001209527900001 ()38684558 (PubMedID)2-s2.0-85191700644 (Scopus ID)
Funder
Region Västerbotten, ALFVLL-298001Region Västerbotten, ALFVLL-643391Swedish Research Council, 521-2013-2708Swedish Research Council, 2016-01891Swedish Heart Lung Foundation, 20150369Swedish Heart Lung Foundation, 20170481Swedish Society of MedicineNorrländska HjärtfondenThe Swedish Stroke AssociationSwedish Social Insurance AgencyVisare NorrThe Swedish Heart and Lung Association
Available from: 2024-05-14 Created: 2024-05-14 Last updated: 2025-02-20Bibliographically approved
Wegdell, G. S., Själander, A., Mukka, S., Åkerstedt, J. & Knutsson, B. (2024). Peri- and postoperative risk for stroke after surgery for lumbar spinal stenosis: a retrospective register study. Paper presented at Eurospine Annual meeting 2024, Vienna, Austria, October 2-4, 2024. Brain and Spine, 4, Article ID 103286.
Open this publication in new window or tab >>Peri- and postoperative risk for stroke after surgery for lumbar spinal stenosis: a retrospective register study
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2024 (English)In: Brain and Spine, E-ISSN 2772-5294, Vol. 4, article id 103286Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Introduction: Surgery for lumbar spinal stenosis (LSS) is one of the most common indications for elective spine surgery in developed countries and postoperative cerebrovascular complications must be taken into consideration. The main objective of this study was to determine and investigate the risk of stroke during the first year after surgery for LSS.

Materials and Methods: This retrospective register study included 64,179 patients from the Swedish spine register (Swespine) operated from 2001 through 2020 for central or lateral LSS. Outcomes were collected from the Swedish stroke register (Riksstroke). The primary outcome was the diagnosis of peri- or postoperative ischemic/hemorrhagic stroke within the first year after LSS surgery. The registers included background data like sex, age, smoking, and previous spine surgery, in addition to surgical/stroke care data like levels of decompression, surgery with instrumentation, type of stroke and length of hospitalisation. Initial analysis with histograms and a life table was used to present the hazard of stroke during the first year after surgery. An adjusted cox regression model was used to analyse the risk for stroke. The model was adjusted for age (<64, 65-74, ≥75), sex, smoking and whether implants were used or not.

Results: During the first year after surgery 426 patients (0,66%) developed a stroke. Out of these 37 (0,06%) were classified as hemorrhagic, 379 (0,59%) as ischemic and 10 (0,02%) as unclassified. The risk for stroke was highest during the first 30 days (n=72, (0,11%)). Smoking (HR, 1,82; 95% CI, 1,31-2,52; p<0,001), age 65-74 years (HR, 2,65; 95% CI, 1,91-3,67; p<0,001) and age ≥75 years (HR, 6,04; 95% CI, 4,42-8,25; p<0,001) were associated as risk factors for postoperative stroke. Surgery with implants was not associated with an increased risk (HR, 1,01; 95% CI, 0,73-1,40; p=0,967).

Conclusion: The peri- and postoperative risk for stroke during the first year after LSS surgery was 0,66% and increased age and smoking were identified as risk factors. The highest number of strokes occurred during the first 30 days and more specific, the first days after surgery. This study gives the basis for further research of cerebrovascular complications after LSS surgery.

Place, publisher, year, edition, pages
Elsevier, 2024
National Category
Neurology Orthopaedics Surgery
Identifiers
urn:nbn:se:umu:diva-236451 (URN)10.1016/j.bas.2024.103286 (DOI)
Conference
Eurospine Annual meeting 2024, Vienna, Austria, October 2-4, 2024
Note

Part of special issue: Abstracts of EUROSPINE 2024

Available from: 2025-03-13 Created: 2025-03-13 Last updated: 2025-03-13Bibliographically approved
Lilja, J., Själander, A. & Själander, S. (2024). Prevalence of atrial fibrillation and reasons for undertreatment with oral anticoagulants. Journal of Thrombosis and Thrombolysis, 57, 101-106
Open this publication in new window or tab >>Prevalence of atrial fibrillation and reasons for undertreatment with oral anticoagulants
2024 (English)In: Journal of Thrombosis and Thrombolysis, ISSN 0929-5305, E-ISSN 1573-742X, Vol. 57, p. 101-106Article in journal (Refereed) Published
Abstract [en]

Objectives: To investigate the prevalence of atrial fibrillation (AF), the proportion of AF patients not receiving oral anticoagulation (OAC) and reasons for abstaining from OAC treatment.

Methods: A retrospective cross-sectional study of patients aged 18 years or older with an AF diagnosis on June 1st 2020 in Västernorrland County, Sweden. AF diagnosis was retrieved using the ICD10 code I.48, and medical records were reviewed for comorbidities and documented reasons to abstain OAC treatment.

Results: Of 197 274 residents in Västernorrland County, 4.7% (9 304/197 274) had a documented AF diagnosis. Of these, 19% (1 768/9 304) had no OAC treatment, including 4.2% (393/9 304) with no indication, 2.5% (233/9 304) with a questionable and 2.5% (231/9 304) with a documented clear contraindication for OAC. In total 9.8% (911/9 304) were not treated with OAC despite indication and no reasonable documented contraindication, thus 90.8% (8 447/9 304) of all AF-patients were eligible for OAC treatment. Common reasons for abstaining treatment without reasonable contraindication were present sinus rhythm in 13.7% (125/911), perceived not an OAC candidate in 10.6% (97/911) and anemia in the past in 4.3% (39/911).

Conclusions: In the population of Västernorrland County, a very high AF prevalence of 4.7% was found, of which just over 90% would theoretically benefit from OAC treatment. This is higher than previously reported and stresses the importance of stroke prevention in this large patient group.

Place, publisher, year, edition, pages
Springer Nature, 2024
Keywords
Atrial fibrillation, Oral anticoagulation, Prevalence
National Category
Cardiology and Cardiovascular Disease Public Health, Global Health and Social Medicine
Identifiers
urn:nbn:se:umu:diva-214615 (URN)10.1007/s11239-023-02890-y (DOI)001066559300001 ()37704908 (PubMedID)2-s2.0-85171163870 (Scopus ID)
Available from: 2023-09-27 Created: 2023-09-27 Last updated: 2025-02-20Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-9422-1186

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