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Inversed relationship between completeness of follow-up and coverage of postoperative complications in gallstone surgery and ERCP: a potential source of bias in patient registers
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences. Sunderby Research Unit, Luleå.
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2018 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 1, article id e019551Article in journal (Refereed) Published
Abstract [en]

Objective: To analyse the completeness in GallRiks of the follow-up frequency in relation to the intraoperative and postoperative outcome.

Design: Population-based register study.

Setting: Data from the national Swedish Registry for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (ERCP), GallRiks.

Population: All cholecystectomies and ERCPs recorded in GallRiks between 1 January 2006 and 31 December 2014.

Main outcome measures: Outcomes for intraprocedural as well as postprocedural adverse events between units with either a 30-day follow-up of AO% compared with those with a less frequent follow-up (<90%).

Results: Between 2006 and 2014, 162 212 cholecystectomies and ERCP procedures were registered in GallRiks. After the exclusion of non-index procedures and those with incomplete data 152 827 procedures remained for final analyses. In patients having a cholecystectomy, there were no differences regarding the adverse event rates, irrespective of the follow-up frequency. However, in the more complicated endoscopic ERCP procedures, the postoperative adverse event rates were significantly higher in those with a more frequent and complete 30-day follow-up (OR 1.92; 95% Cl 1.76 to 2.11).

Conclusions: Differences in the follow-up frequency in registries affect the reported outcomes as exemplified by the complicated endoscopic ERCP procedures. A high and complete follow-up rate shall serve as an additional quality indicator for surgical registries.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018. Vol. 8, no 1, article id e019551
National Category
Surgery
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URN: urn:nbn:se:umu:diva-148039DOI: 10.1136/bmjopen-2017-019551ISI: 000431743500090PubMedID: 29362270OAI: oai:DiVA.org:umu-148039DiVA, id: diva2:1211020
Available from: 2018-05-30 Created: 2018-05-30 Last updated: 2018-06-09Bibliographically approved

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Enochsson, Lars

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