| 1. |
- Bengtsson, H, et al.
(författare)
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Expansion pattern and risk of rupture of abdominal aortic aneurysms that were not operated on
- 1993
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Ingår i: European Journal of Surgery. - 1102-4151. ; 159:9, s. 461-467
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To analyse the outcome of selective management of patients with abdominal aortic aneurysms, the expansion patterns of the aneurysms, and the factors that influenced the rate of rupture. DESIGN: Retrospective study. SETTING: Malmo General Hospital, Lund University, Malmo, Sweden. SUBJECTS: 155 patients (96 men and 59 women) with abdominal aortic aneurysms who were not selected for operation for whatever reason were included in the study immediately after their first ultrasound scan. MAIN OUTCOME MEASURES: Mortality, expansion rate (mm/year) measured on ultrasound scan, and rate of rupture of aneurysm. RESULTS: Median aneurysmal diameter was 40 mm (range 20-80), and length (n = 106) 70 (range 28-140). The patients were followed up for a median of 3.4 years (range 0-10.2). A total of 107 patients died and in 21 the aneurysms ruptured (4 were operated on and survived). Thirteen patients were re-evaluated and operated on electively. Ultrasonography was repeated in 98 patients, the median expansion rates (mm/year) were 3.1 (diameter) and 1.9 (length). There was a significant linear relationship between initial size (diameter and length) and rate of expansion of diameter. The risk of rupture was greater in larger aneurysms that were expanding more quickly. The cumulative mortality was not affected by the 21 aneurysms that ruptured. CONCLUSION: Selective management of patients with aortic aneurysms is justified.
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| 2. |
- Hansen, F, et al.
(författare)
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Non-invasive measurement of pulsatile vessel diameter change and elastic properties in human arteries: a methodological study
- 1993
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Ingår i: Clinical Physiology. - 1365-2281. ; 13:6, s. 631-643
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Tidskriftsartikel (refereegranskat)abstract
- A recently developed ultrasound phase-locked echo-tracking system makes it possible to measure non-invasive pulsatile vessel diameter changes, and, in combination with blood-pressure measurement, to calculate pressure strain elastic modulus (Ep) and stiffness (beta). The reproducibility in measurements of pulsatile diameter changes with this system was evaluated. Also the precision of indirect blood-pressure measurements, as compared to the simultaneously measured intra-arterial blood pressure was tested. The resulting reproducibility in pressure strain elastic modulus (Ep) and stiffness (beta) was evaluated. Intra-observer variabilities in measuring pulsatile diameter changes were 16% for the abdominal aorta, 10% for the common carotid artery, and 15% for the common femoral artery, respectively. Intra-observer variabilities for Ep and beta were 21% for both in the abdominal aorta, 17% for both in the common carotid artery, and 18% for both in the common femoral artery, respectively. There were only small differences in indirect and direct measurement of systolic blood pressure, whereas indirect blood pressure measurement systematically overestimated the diastolic blood pressure, on average by 20%. The variabilities in indirect blood pressure measurements were 2% for the systolic and 3% for the diastolic blood pressure, respectively. Inter-observer variability in the investigation of the common carotid artery was 10% for the pulsatile diameter changes, and 21% and 23% for Ep and beta, respectively. Thus, the echo-tracking system represents a reliable system for estimation of pressure strain elastic modulus and stiffness. However, Ep and beta are systematically underestimated by 25-30%, when used in combination with indirect blood pressure measurements.
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| 3. |
- Bergqvist, D, et al.
(författare)
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Die Kosteneffektivitat in der Pravention postoperativer Thromboembolien
- 1993
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Ingår i: Orthopade. - 1433-0431. ; 22:2, s. 140-143
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Tidskriftsartikel (refereegranskat)abstract
- Awareness of cost-effectiveness aspects has become increasingly important within the health care sector in times of constrained resources. Health economics deal with methods of making choices under conditions of uncertainty and provide models for decision making. A key question is to compare alternative strategies. Within the field of prophylaxis against venous thromboembolism general thromboprophylaxis is cost-effective provided that the frequency of deep vein thrombosis is higher than 10%. Diagnostic screening and selective treatment of detected thrombosis is always the least cost-effective alternative. Although detailed analyses are still lacking it seems as if the use of low molecular weight heparins is more cost-effective than unfractionated low dose heparin. Besides saving lives by preventing fatal pulmonary embolism an adequate thromboprophylaxis also will provide monetary savings.
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| 4. |
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| 5. |
- Bergqvist, D, et al.
(författare)
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Thromboprophylaxis in emergency surgery
- 1993
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Ingår i: Haemostasis. - 0301-0147. ; 23:Suppl. 1, s. 51-56
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Tidskriftsartikel (refereegranskat)abstract
- Except for hip fracture surgery, emergency surgery has been only exceptionally studied concerning thromboprophylaxis. There are, however, several reasons to believe the frequency to be fairly high and that the patient group would be in need of prophylaxis. This paper discusses various emergency situations and also gives the design for an ongoing controlled study on the effect of postoperative start of thromboprophylaxis with low molecular weight heparin in emergency abdominal surgery.
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