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- Rystedt, J. M.L., et al.
(författare)
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Routine versus selective intraoperative cholangiography during cholecystectomy: systematic review, meta-analysis and health economic model analysis of iatrogenic bile duct injury
- 2021
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Ingår i: BJS open. - Oxford : Oxford University Press (OUP). - 2474-9842. ; 5:2
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Tidskriftsartikel (refereegranskat)abstract
- Background: Bile duct injury (BDI) is a severe complication following cholecystectomy. Early recognition and treatment of BDI has been shown to reduce costs and improve patients' quality of life. The aim of this study was to assess the effect and cost-effectiveness of routine versus selective intraoperative cholangiography (IOC) in cholecystectomy. Methods: A systematic review and meta-analysis, combined with a health economic model analysis in the Swedish setting, was performed. Costs per quality-adjusted life-year (QALY) for routine versus selective IOC during cholecystectomy for different scenarios were calculated. Results: In this meta-analysis, eight studies with more than 2 million patients subjected to cholecystectomy and 9000 BDIs were included. The rate of BDI was estimated to 0.36 per cent when IOC was performed routinely, compared with to 0.53 per cent when used selectively, indicating an increased risk for BDI of 43 per cent when IOC was used selectively (odds ratio 1.43, 95 per cent c.i. 1.22 to 1.67). The model analysis estimated that seven injuries were avoided annually by routine IOC in Sweden, a population of 10 million. Over a 10-year period, 33 QALYs would be gained at an approximate net cost of (sic)808 000 , at a cost per QALY of about (sic)24 900. Conclusion: Routine IOC during cholecystectomy reduces the risk of BDI compared with the selective strategy and is a potentially cost-effective intervention.
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| 2. |
- Johansson, Ingrid, et al.
(författare)
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Coping strategies of relatives when an adult next-of-kin is recovering at home following critical illness
- 2004
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Ingår i: Intensive and Critical Care Nursing. - Edinburgh : Elsevier BV. - 0964-3397 .- 1532-4036. ; 20:5, s. 281-291, s. 281-71
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Tidskriftsartikel (refereegranskat)abstract
- The trend within the Swedish healthcare system is to reduce the duration of hospital care. This means that a patient who is discharged to their home after critical illness is highly likely to be functionally impaired, and therefore, requires care-giving assistance from a family member. The aim of this study was to generate a theoretical model with regard to relatives’ coping when faced with the situation of having an adult next-of-kin recovering at home after critical illness. The design incorporated grounded theory methodology. Four coping strategies exhibiting different characteristics were identified: volunteering, accepting, modulating and sacrificing. Factors determining the choice of coping strategy were the physical and psychological status of the relative, previous experience of ICU-care and the psychological status of the patient. The theoretical model described in this article can contribute to expanding healthcare professionals’ understanding of the coping strategies of relatives during recovery, but also provide inspiration for social action to be taken.
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| 3. |
- Mundy, Lee G., et al.
(författare)
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High-resolution images of the Orion molecular ridge in the CS J = 2-1 transition
- 1988
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Ingår i: Astrophysical Journal. - Philadelphia, PA : Institute of Physics Publishing (IOPP). - 0004-637X .- 1538-4357. ; 325:1, s. 382-388
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Tidskriftsartikel (refereegranskat)abstract
- The authors have constructed 7arcsec.5 resolution images of the CS J = 2-1 emission from a 3arcmin.5 section of the Orion molecular ridge using a maximum entropy algorithm to combine Owens Valley Millimeter-Wave Interferometer and Onsala Space Observatory 20 m data. The resulting images include all of the flux and have positional accuracy of 1arcsec-2arcsec on the small-scale features. The observed section of the ridge includes four condensations. The condensations have dimensions from 0.03 to 0.11 pc and virial massses from 30 to 80 M_sun;. Approximately 70% of the total mass within the 3arcmin region is contained in these condensations.
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