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Validation of adverse events after hip arthroplasty : a Swedish multi-centre cohort study.

Magnéli, Martin (author)
Karolinska Institutet
Unbeck, Maria (author)
Karolinska Institutet, Sweden;Karolinska University Hospital, Sweden
Rogmark, Cecilia (author)
Skåne University Hospital, Sweden
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Rolfson, Ola, 1973 (author)
Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics
Hommel, Ami (author)
Malmö universitet,Institutionen för vårdvetenskap (VV),Malmö University, Sweden;Skåne University Hospital, Sweden
Samuelsson, Bodil (author)
Karolinska Institutet
Schildmeijer, Kristina, 1959- (author)
Linnéuniversitetet,Institutionen för hälso- och vårdvetenskap (HV),reaction
Sjöstrand, Desirée (author)
Skånevård Kryh, Sweden
Gordon, Max (author)
Karolinska Institutet, Sweden;Danderyd Hospital, Sweden
Sköldenberg, Olof (author)
Karolinska Institutet
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 (creator_code:org_t)
2019-03-07
2019
English.
In: BMJ Open. - : BMJ. - 2044-6055. ; 9:3
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • OBJECTIVES: Preventing adverse events (AEs) after orthopaedic surgery is a field with great room for improvement. A Swedish instrument for measuring AEs after hip arthroplasty based on administrative data from the national patient register is used by both the Swedish Hip Arthroplasty Register and the Swedish Association of Local Authorities and Regions. It has never been validated and its accuracy is unknown. The aim of this study was to validate the instrument's ability to detect AEs, and to calculate the incidence of AEs following primary hip arthroplasties.DESIGN: Retrospective cohort study using retrospective record review with Global Trigger Tool methodology in combination with register data.SETTING: 24 different hospitals in four major regions of Sweden.PARTICIPANTS: 2000 patients with either total or hemi-hip arthroplasty were recruited from the SHAR. We included both acute and elective patients.PRIMARY AND SECONDARY OUTCOME MEASURES: The sensitivity and specificity of the instrument. Adjusted cumulative incidence and incidence rate.RESULTS: The sensitivity for all identified AEs was 5.7% (95% CI: 4.9% to 6.7%) for 30 days and 14.8% (95% CI: 8.2 to 24.3) for 90 days, and the specificity was 95.2% (95% CI: 93.5% to 96.6%) for 30 days and 92.1% (95% CI: 89.9% to 93.8%) for 90 days. The adjusted cumulative incidence for all AEs was 28.4% (95% CI: 25.0% to 32.3%) for 30 days and 29.5% (95% CI: 26.0% to 33.8%) for 90 days. The incidence rate was 0.43 AEs per person-month (95% CI: 0.39 to 0.47).CONCLUSIONS: The AE incidence was high, and most AEs occurred within the first 30 days. The instrument sensitivity for AEs was very low for both 30 and 90 days, but the specificity was high for both 30 and 90 days. The studied instrument is insufficient for valid measurements of AEs after hip arthroplasty.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Health Sciences (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Ortopedi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Orthopaedics (hsv//eng)

Keyword

adverse events
global trigger tool
hip arthroplasty
orthopaedics
validation
Hälsovetenskap
risk-factors
hospitals
General & Internal Medicine

Publication and Content Type

ref (subject category)
art (subject category)

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