Data Quality of Surgery for Carotid Artery Stenosis. Are the National Vascular Registries Reliable?

AbstractObjectivesTo study completeness of reporting carotid endarterectomies, including peri-operative stroke and mortality rate, in a national vascular registry, NorKar, and a national administrative registry, The Norwegian Patient Register (NPR).DesignComparative registry-based national study.MaterialsMember hospitals of NorKar, including 89% of carotid endarterectomies in Norway, were compared with relevant data in NPR for the years 2000–2002.MethodsWe compared procedure-codes, diagnosis-codes, in-hospital death and the occurrence of peri-operative stroke after treatment for carotid artery stenosis in the two registries to evaluate completeness.ResultsCompared with the NPR numbers, 16% of carotid endarterectomies were missing in the reports from member hospitals of NorKar. Further, during this three-year period, there was an under-reporting of seven strokes and two deaths. The discrepancy was most pronounced in 2001.ConclusionsThere is an under-reporting of patients operated on for carotid artery stenosis in NorKar according to NPR numbers as well as an under-reporting of early deaths and strokes. There is a need for better quality data in the NorKar Registry. Registry quality would be likely to improve if patient identifiable data were available in both registries

Quality of Data Reported on Abdominal Aortic Aneurysm Repair—A Comparison between a National Vascular and a National Administrative Registry

AbstractObjectiveTo study consistency of data and completeness of reporting in a national vascular registry, NorKar, and a national administrative registry, The Norwegian patient register (NPR).DesignComparative registry-based national study supplemented with a comprehensive control of patients registered in one major hospital.MaterialAll patients registered with a procedure-code for treatment of AAA in NorKar or NPR during 2001 or 2002, were included.MethodWe compared the reporting of procedure-codes, diagnosis-codes and in-hospital deaths after treatment for abdominal aortic aneurysm (AAA) in the two registries to evaluate completeness. Consistency between procedure-codes and diagnoses were evaluated within both registries. Completeness of reporting to one NorKar Local Registry was investigated in more detail in one of the hospitals.ResultsCompared with the NPR numbers, NorKar contained 69% of the patients treated for AAA in Norway, while completeness for NorKar member hospitals was 84%. The detailed investigation in one of the hospitals showed a completeness of 91% and a false inclusion of 5.3% of all cases treated for AAA. The consistency between procedure-codes and diagnosis-codes was 93% in both registries. We found evidence of substantial underreporting of in-hospital deaths to NorKar in several hospitals. Overall reporting of early deaths to NorKar relative to completeness of reported cases was estimated to 72%.ConclusionThere is an underreporting of patients with AAA to NorKar according to the NPR numbers and a need for better control of procedure-diagnosis consistency in both registries. There seems to be a substantial underreporting of early deaths to NorKar. Introduction of unique patient-identifiable data could improve the quality of both registries by making matching of data possible

DynaCT during EVAR – A Comparison with Multidetector CT

AbstractObjectivesWe have explored the usefulness of an on-table, cross-sectional radiological imaging (DynaCT) in endovascular aortic repair (EVAR). DynaCT images were compared to images from a regular multidetector (16 slice) CT. In the comparison, we tested the accordance of firstly 5 relevant clinical measurements and secondly the visibility of 9 anatomical areas in the two different types of images. This imaging was carried out in addition to the usual angiographic imaging.Design, material and method20 patients with infrarenal abdominal aortic aneurysm (AAA) were prospectively enrolled in the study. We compared Images from DynaCT with two different doses of contrast medium to MDCT-images in two different ways. Firstly relevant arterial diameters and lengths and secondly, 9 anatomical areas were evaluated regarding visibility which was scored on a 4-point scale.ResultsThere were no significant differences in the measured arterial diameters and lengths. MDCT had a significantly higher visibility score than both DynaCT investigations. However, with the highest contrast medium dose we found acceptable diagnostic quality in 78–94% of the cases for 8 of the 9 investigated anatomical areas.ConclusionOur findings indicate that on-table DynaCT are of sufficient quality to give relevant information of arterial measurements, needed in endovascular repair of infrarenal aortic aneurysms