Establishment of a national Danish hysterectomy database: Preliminary report on the first 13,425 hysterectomies

Charlotte T. Hansen, Charlotte Møller, Signe Daugbjerg, Jan Utzon, Henrik Kehlet, Bent Ottesen*, Jan Blaakær, Margit Dueholm, Gitte Eriksen, Helga Gimbel, Charlotte Thim Hansen, Peter Hornnes, Niels Kjærgaard, Ulla Breth Knudsen, Lydia De Lassen, Øjvind Lidegaard, Ole Mogensen, Dorte Nielsen, Kjeld Leisgaard Rasmussen, Annette Settnes

*Corresponding author af dette arbejde

    Publikation: Bidrag til tidsskriftArtikelForskningpeer review

    Abstract

    Objective. To describe the concept and early results from the Danish Hysterectomy Database (DHD). Design. Nationwide prospective cohort. Setting. Denmark. Population. All women who had undergone an elective hysterectomy for benign indication carried out in 2004-2006. Methods. Structured data are registered prospectively by the surgeons involved in the treatment. Data is reported using the Danish National Patient Registry (LPR) and feedback is provided as clinical indicators with well-defined goals. The DHD concept includes annual plenary meetings, elaboration of national clinical guidelines and parallel causal studies. Main outcome measures. Completeness, data validation and department-identifiable clinical indicators (surgical volume, method of hysterectomy, use of antibiotic and thromboembolic prophylaxis, postoperative hospitalization and bleeding complications, surgical infections, reoperations, readmissions and death within 30 days postoperatively). Results. A total of 13,425 hysterectomies were performed in Denmark from 2004 to 2006. In 2005, all gynecological departments in Denmark (n=31) were included in the database collaboration and the national response rate was 99%. Data validity was good in general (82-100% agreement and κ=0.40-1.00) and data completeness was high (92-100% in 2006). From 2004 to 2006, two clinical guidelines were implemented, the postoperative hospitalization was stable at median 2 days, the rate of postoperative surgical infections was reduced from 4 to 2%, the rate of bleeding complications from 8 to 6%, the reoperation rate from 5 to 4%, and the readmission rate from 7 to 5%. Conclusions. Clinical performance indicators, audit meetings and nationwide collaboration are useful in monitoring and improving outcome after hysterectomy on a national level. In addition, the DHD offers scope for causal studies about perioperative management.

    OriginalsprogEngelsk
    Sider (fra-til)546-557
    Antal sider12
    TidsskriftActa Obstetricia et Gynecologica Scandinavica
    Vol/bind87
    Udgave nummer5
    DOI
    StatusUdgivet - 15 maj 2008

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