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  • Biancari, Fausto; Mariscalco, Giovanni; Yusuff, Hakeem; Tsang, Geoffrey; Luthra, Suvitesh; Onorati, Francesco; Francica, Alessandra; Rossetti, Cecilia; Perrotti, Andrea; Chocron, Sidney; Fiore, Antonio; Folliguet, Thierry; Pettinari, Matteo; Dell'Aquila, Angelo M.; Demal, Till; Conradi, Lenard; Detter, Christian; Pol, Marek; Ivak, Peter; Schlosser, Filip; Forlani, Stefano; Chetty, Govind; Harky, Amer; Kuduvalli, Manoj; Field, Mark; Vendramin, Igor; Livi, Ugolino; Rinaldi, Mauro; Ferrante, Luisa; Etz, Christian; Noack, Thilo; Mastrobuoni, Stefano; De Kerchove, Laurent; Jormalainen, Mikko; Laga, Steven; Meuris, Bart; Schepens, Marc; El Dean, Zein; Vento, Antti; Raivio, Peter; Borger, Michael; Juvonen, Tatu (2021)
    Background: Acute Stanford type A aortic dissection (TAAD) is a life-threatening condition. Surgery is usually performed as a salvage procedure and is associated with significant postoperative early mortality and morbidity. Understanding the patient's conditions and treatment strategies which are associated with these adverse events is essential for an appropriate management of acute TAAD. Methods: Nineteen centers of cardiac surgery from seven European countries have collaborated to create a multicentre observational registry (ERTAAD), which will enroll consecutive patients who underwent surgery for acute TAAD from January 2005 to March 2021. Analysis of the impact of patient's comorbidities, conditions at referral, surgical strategies and perioperative treatment on the early and late adverse events will be performed. The investigators have developed a classification of the urgency of the procedure based on the severity of preoperative hemodynamic conditions and malperfusion secondary to acute TAAD. The primary clinical outcomes will be in-hospital mortality, late mortality and reoperations on the aorta. Secondary outcomes will be stroke, acute kidney injury, surgical site infection, reoperation for bleeding, blood transfusion and length of stay in the intensive care unit. Discussion: The analysis of this multicentre registry will allow conclusive results on the prognostic importance of critical preoperative conditions and the value of different treatment strategies to reduce the risk of early adverse events after surgery for acute TAAD. This registry is expected to provide insights into the long-term durability of different strategies of surgical repair for TAAD.
  • Ruohoalho, Johanna; Ostvoll, Eirik; Bratt, Mette; Bugten, Vegard; Bäck, Leif; Mäkitie, Antti; Ovesen, Therese; Stalfors, Joacim (2018)
    Surgical quality registers provide tools to measure and improve the outcome of surgery. International register collaboration creates an opportunity to assess and critically evaluate national practices, and increases the size of available datasets. Even though millions of yearly tonsillectomies and tonsillotomies are performed worldwide, clinical practices are variable and inconsistency of evidence regarding the best clinical practice exists. The need for quality improvement actions is evident. We aimed to systematically investigate the existing tonsil surgery quality registers found in the literature, and to provide a thorough presentation of the planned Nordic Tonsil Surgery Register Collaboration. A systematic literature search of MEDLINE and EMBASE databases (from January 1990 to December 2016) was conducted to identify registers, databases, quality improvement programs or comprehensive audit programs addressing tonsil surgery. We identified two active registers and three completed audit programs focusing on tonsil surgery quality registration. Recorded variables were fairly similar, but considerable variation in coverage, number of operations included and length of time period for inclusion was discovered. Considering tonsillectomies and tonsillotomies being among the most commonly performed surgical procedures in otorhinolaryngology, it is surprising that only two active registers could be identified. We present a Nordic Tonsil Surgery Register Collaboration-an international tonsil surgery quality register project aiming to provide accurate benchmarks and enhance the quality of tonsil surgery in Denmark, Finland, Norway and Sweden.