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Träfflista för sökning "(L773:1078 5884 OR L773:1532 2165) pers:(Lees T) srt2:(2012)"

Sökning: (L773:1078 5884 OR L773:1532 2165) pers:(Lees T) > (2012)

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1.
  • Lees, T, et al. (författare)
  • International Variations in Infrainguinal Bypass Surgery : A VASCUNET Report
  • 2012
  • Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 44:2, s. 185-192
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES:To compare practice in lower limb bypass surgery in nine countries.DESIGN:A prospective study amalgamating and analysing data from national and regional vascular registries.METHODS:A table of data fields and definitions was agreed by all member countries of the Vascunet Collaboration. Data from January 2005 to December 2009 was submitted to a central database.RESULTS:32,084 cases of infrainguinal bypass (IIB) in nine countries were analysed. Procedures per 100,000 population varied between 2.3 in the UK and 24.6 in Finland. The proportion of women varied from 25% to 43.5%. The median age for all countries was 70 for men and 76 for women. Hungary treated the youngest patients. IIB was performed for claudication for between 15.7% and 40.8% of all procedures. Vein grafts were used in patients operated on for claudication (52.9%), for rest pain (66.7%) and tissue loss (74.1%). Italy had the highest use of synthetic grafts. Among claudicants 45% of bypasses were performed to the below knee popliteal artery or more distally. Graft patency at 30 days varied between 86% and 99%.CONCLUSIONS: Significant variations in practice between countries were demonstrated. These results should be interpreted alongside the known limitations of such registry data with respect to quality and completeness of the data. Variation in data completeness and data validation between countries needs to be improved for useful international comparison of outcomes.
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2.
  • Vikatmaa, P, et al. (författare)
  • Variation in Clinical Practice in Carotid Surgery in Nine Countries 2005-2010. Lessons from VASCUNET and Recommendations for the Future of National Clinical Audit
  • 2012
  • Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 44:1, s. 11-17
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES:The aim of the study was to analyse variation in carotid surgical practice, results and effectiveness in nine countries.PATIENTS AND METHODS:A total of 48,185 carotid endarterectomies (CEAs) and 4602 carotid artery stenting (CAS) procedures were included in the comparison. A theoretical effectiveness of CEA provision for each country was estimated.RESULTS:92.6% of the CEAs were performed according to the inclusion criteria based on the current European recommendations and had a theoretical benefit for the patient. The indication for surgery was symptomatic stenosis in 60.1% and this proportion varied between 31.4% in Italy and 100% in Denmark. The overall combined stroke and death rate in symptomatic patients was 2.3%. This varied between rates of 0.9% in Italy and 3.8% in Norway. The overall combined stroke and death rate in asymptomatic patients was 0.9%. It was lowest in Italy at 0.5%, and highest in Sweden at 2.7%. We estimated that the stroke prevention rate per 1000 CEAs varied from 72.9 in Italy to 130.8 in Denmark.CONCLUSIONS:There is significant variation in clinical practice across the participating countries. The theoretical stroke prevention potential of CEA seems to vary between participating countries due to differences in the inclusion criteria.
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Björck, Martin (2)
Venermo, M (2)
Mitchell, D (2)
Beiles, B (2)
Wigger, P (2)
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Troëng, Thomas (2)
Lees, T (2)
Jensen, L. P. (2)
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