Dansk Hysterektomi og Hysteroskopi Database - DSOG

Indholdsfortegnelse
Forord…………………………………………………………………….2
1.
 Målsætning................................................................................ 4
2.
 Konklusion ................................................................................ 5
3.
 Anbefalinger.............................................................................. 8
3.1.
 Generelle anbefalinger......................................................................... 8
3.2.
 Anbefalinger og tiltag på baggrund af analyser for 2011 ................. 9
4.
 Baggrund................................................................................. 10
4.1.
 Organisering ....................................................................................... 12
4.1.1.
 Styregruppe og daglig ledelse........................................................................................ 12
4.1.2.
 Afdelingsrepræsentanter ................................................................................................ 12
5.
 Dataindsamling og metode.................................................... 12
5.1.
 Indberetningssystem ......................................................................... 12
5.2.
 Registreringsskema ........................................................................... 12
5.3.
 Dataanalyse......................................................................................... 13
5.4.
 Risikojustering.................................................................................... 13
5.5.
 Vejledning i fortolkning af risikojusterede analyser ....................... 13
5.5.1.
 Odds Ratio (OR) ............................................................................................................... 13
5.5.2.
 Konfidensinterval (KI) og statistisk signifikans ............................................................ 13
5.5.3.
 Ujusterede OR .................................................................................................................. 14
5.5.4.
 Justerede OR.................................................................................................................... 14
5.6.
 Afrapportering .................................................................................... 14
5.7.
 Dækningsgrad .................................................................................... 14
5.8.
 Komplethed......................................................................................... 16
5.8.1.
 Datakomplethed ............................................................................................................... 16
5.8.2.
 Variabelkomplethed ......................................................................................................... 17
6.
 Resultater ................................................................................ 18
6.1.
 Risikovariable ..................................................................................... 19
6.1.1.
 Indikation .......................................................................................................................... 19
6.1.2.
 Alder .................................................................................................................................. 20
6.1.3.
 BMI..................................................................................................................................... 21
6.1.4.
 ASA-klasse ....................................................................................................................... 21
6.1.5.
 Tobak................................................................................................................................. 22
6.1.6.
 Alkohol .............................................................................................................................. 22
6.1.7.
 Uterus vægt ...................................................................................................................... 23
6.1.8.
 Kendt kronisk sygdom .................................................................................................... 23
6.2.
 Prognostiske faktorer ........................................................................ 23
6.2.1.
 Operatør- og assistenterfaring ....................................................................................... 24
6.2.2.
 Knivtid ............................................................................................................................... 24
6.2.3.
 Deloperationer.................................................................................................................. 25
6.2.4.
 Anæstesiform ................................................................................................................... 25
6.2.5.
 Smertestillende regime.................................................................................................... 25
7.
 Indikatorer ............................................................................... 26
Indikator 1: Volumen ................................................................... 27
Indikator 2a: Hysterektomimetode…………............................... 29
Indikator 2b: Total/subtotal hysterektomi ................................. 31