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| 2. |
- Ludvigsson, Jonas F, et al.
(författare)
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External review and validation of the Swedish national inpatient register.
- 2011
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Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 11, s. 450-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Swedish National Inpatient Register (IPR), also called the Hospital Discharge Register, is a principal source of data for numerous research projects. The IPR is part of the National Patient Register. The Swedish IPR was launched in 1964 (psychiatric diagnoses from 1973) but complete coverage did not begin until 1987. Currently, more than 99% of all somatic (including surgery) and psychiatric hospital discharges are registered in the IPR. A previous validation of the IPR by the National Board of Health and Welfare showed that 85-95% of all diagnoses in the IPR are valid. The current paper describes the history, structure, coverage and quality of the Swedish IPR. METHODS AND RESULTS: In January 2010, we searched the medical databases, Medline and HighWire, using the search algorithm "validat* (inpatient or hospital discharge) Sweden". We also contacted 218 members of the Swedish Society of Epidemiology and an additional 201 medical researchers to identify papers that had validated the IPR. In total, 132 papers were reviewed. The positive predictive value (PPV) was found to differ between diagnoses in the IPR, but is generally 85-95%. CONCLUSIONS: In conclusion, the validity of the Swedish IPR is high for many but not all diagnoses. The long follow-up makes the register particularly suitable for large-scale population-based research, but for certain research areas the use of other health registers, such as the Swedish Cancer Register, may be more suitable.
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| 3. |
- Strålin, Kristoffer, et al.
(författare)
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Mortality in hospitalized COVID-19 patients was associated with the COVID-19 admission rate during the first year of the pandemic in Sweden
- 2022
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Ingår i: Infectious Diseases. - : Taylor & Francis Ltd. - 2374-4235 .- 2374-4243. ; 54:2, s. 145-151
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Studies from the first pandemic wave found associations between COVID-19 hospital load and mortality. Here, we aimed to study if mortality of hospitalized COVID-19 patients was associated with the COVID-19 admission rate during a full year of the pandemic in Sweden. Method Observational review of all patients admitted to hospital with COVID-19 in Sweden between March 2020 and February 2021 (n = 42,017). Primary outcome was 60-day all-cause mortality related to number of COVID-19 hospital admissions per month/100,000 inhabitants. Poisson regression was used to estimate the relative risk for death by month of admission, adjusting for pre-existing factors. Results The overall mortality was 17.4%. Excluding March 2020, mortality was clearly correlated to the number of COVID-19 admissions per month (coefficient of correlation rho=.96; p<.0001). After adjustment for pre-existing factors, the correlation remained significant (rho=.75, p=.02). Patients admitted in December (high admission rate and high mortality) had more comorbidities and longer hospital stays, and patients treated in intensive care units (ICU) had longer pre-ICU hospital stays and worse respiratory status on ICU admission than those admitted in July to September (low admission rate and low mortality). Conclusion Mortality in hospitalized COVID-19 patients was clearly associated with the COVID-19 admission rate. Admission of healthier patients between pandemic waves and delayed ICU care during wave peaks could contribute to this pattern. The study supports measures to flatten-the-curve to reduce the number of COVID-19 patients admitted to hospital.
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| 4. |
- Strålin, Kristoffer, et al.
(författare)
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Mortality trends among hospitalised COVID-19 patients in Sweden : A nationwide observational cohort study
- 2021
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Ingår i: The Lancet Regional Health. - : Elsevier. - 2666-7762. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Background: It is important to know if mortality among hospitalised COVID-19 patients has changed as the pandemic has progressed. The aim of this study was to describe the dynamics over time of mortality among patients hospitalised for COVID-19 in Sweden, using nationwide data compiled by the Swedish National Board of Health and Welfare. Methods: Observational cohort study where all patients hospitalised in Sweden between March 1 and September 30, 2020, with SARS-CoV-2 RNA positivity 14 days before to 5 days after admission and a discharge code for COVID-19 were included. Outcome was 60-day all-cause mortality. Patients were categorised according to month of hospital admission. Poisson regression was used to estimate the relative risk of death by month of admission, adjusting for, age, sex, comorbidities, care dependency, country of birth, healthcare region, and Simplified Acute Physiology, version 3 (patients in intensive care units; ICU). Findings: A total of 17,140 patients were included, of which 2943 died within 60 days of admission. The overall 60-day mortality was thus 17.2% (95% CI, 16.6%-17.7%), and it decreased from 24.7% (95% CI, 23.0%-26.5%) in March to 10.4% (95% CI, 8.9%-12.1%) post-wave (July-September). Adjusted relative risk (RR) of death was 0.46 (95% CI, 0.39-0.54) post-wave, using March as reference. Corresponding RR for patients not admitted to ICU and those admitted to ICU were 0.49 (95% CI, 0.42-0.59) and 0.49 (95% CI, 0.33-0.72), respectively. The proportion of patients admitted to ICU decreased from 19.4% (95% CI, 17.9%-21.1%) in the March cohort to 8.9% (95% CI, 7.5%-10.6%) post-wave. Interpretation: There was a gradual decline in mortality during the spring of 2020 in Swedish hospitalised COVID-19 patients, independent of baseline patient characteristics. Future research is needed to explain the reasons for this decline. The changing COVID-19 mortality should be taken into account when management and results of studies from the first pandemic wave are evaluated. (C) 2021 The Authors. Published by Elsevier Ltd.
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