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Cervin, A., Wanhainen, A. & Björck, M. (2020). Popliteal aneurysms are common among men with screening detected abdominal aortic aneurysms, and prevalence correlates with the diameters of the common iliac arteries. European Journal of Vascular and Endovascular Surgery, 59(1), 67-72
Öppna denna publikation i ny flik eller fönster >>Popliteal aneurysms are common among men with screening detected abdominal aortic aneurysms, and prevalence correlates with the diameters of the common iliac arteries
2020 (Engelska)Ingår i: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 59, nr 1, s. 67-72Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Data on the prevalence of popliteal artery aneurysm (PA) are scarce and difficult to interpret as the definition differs among papers. The aim was to investigate the prevalence among men with screening detected abdominal aortic aneurysms (>= 30 mm, AAAs) and subaneurysmal aortic dilatation (25-29 mm, SAA), and to explore whether the existence of a PA correlated with the diameters of the aorta, iliac, and femoral arteries.

Methods: In Uppsala, Sweden, a county with 376 000 inhabitants, AAA screening of 65 year old men was initiated in 2006. All men with AAA and SAA also had measurements of the common iliac artery (CIA). The common femoral (CFA), superficial femoral (SFA), and popliteal arteries were evaluated at re-examination, performed after 1-2 years for AAA and five years for SAA. PA was defined as >= 12 mm, or 1.5 times larger than the distal SFA according to the ISCVS/SVS Ad Hoc Committee. The relationships between PA and other vessel diameters were explored.

Results: A total of 19 820 65 year old men (84.6%) accepted the invitation to screening between 2006 and 2017. AAA was found in 173 (0.9%), and SAA in 149 subjects (1.1% of those screened 2006-2013, eligible for this study). In the whole cohort, 14.2% of those examined had at least one PA of any size, 3.0% were >= 15 mm and 2.2% >= 20 mm. There was no difference in PA prevalence between AAA and SAA: 15.9% vs. 12.2% (p = .48). There was no difference in aortic diameter in those with or without PA (p = .46), but there were significant correlations with CIA (p < .001), CFA (p < .001), and SFA (p < .001) diameters.

Conclusions: A high prevalence of PA among subjects with screening detected AAA and SAA was found. PA was not correlated with the aortic diameter in this cohort, where all had dilated aortas, while correlations with peripheral and iliac artery diameters were identified.

Nyckelord
Abdominal aortic aneurysm; Popliteal artery aneurysm; Iliac artery; Screening, Prevalence.
Nationell ämneskategori
Kirurgi
Forskningsämne
Kirurgi
Identifikatorer
urn:nbn:se:uu:diva-381518 (URN)10.1016/j.ejvs.2019.07.042 (DOI)000506204700013 ()31757587 (PubMedID)
Anmärkning

Title in dissertation list of papers: Popliteal aneurysms are common among men with screening detected abdominal aortic aneurysms, and the prevalence is correlated with the diameters of the common iliac arteries

Tillgänglig från: 2019-04-10 Skapad: 2019-04-10 Senast uppdaterad: 2020-01-27Bibliografiskt granskad
Högberg, D. & Björck, M. (2020). Response to "Re. Five Year Outcomes in Men Screened for Carotid Artery Stenosis at 65 Years of Age: A Population Based Cohort Study" [Letter to the editor]. European Journal of Vascular and Endovascular Surgery, 59(1), 152-152
Öppna denna publikation i ny flik eller fönster >>Response to "Re. Five Year Outcomes in Men Screened for Carotid Artery Stenosis at 65 Years of Age: A Population Based Cohort Study"
2020 (Engelska)Ingår i: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 59, nr 1, s. 152-152Artikel i tidskrift, Letter (Övrigt vetenskapligt) Published
Ort, förlag, år, upplaga, sidor
W B SAUNDERS CO LTD, 2020
Nationell ämneskategori
Kirurgi
Identifikatorer
urn:nbn:se:uu:diva-403534 (URN)10.1016/j.ejvs.2019.07.036 (DOI)000506204700029 ()31473055 (PubMedID)
Tillgänglig från: 2020-01-31 Skapad: 2020-01-31 Senast uppdaterad: 2020-01-31Bibliografiskt granskad
Dick, F. & Björck, M. (2020). The EJVES is Taking the Next Step Anew. European Journal of Vascular and Endovascular Surgery, 59(1), 1-2
Öppna denna publikation i ny flik eller fönster >>The EJVES is Taking the Next Step Anew
2020 (Engelska)Ingår i: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 59, nr 1, s. 1-2Artikel i tidskrift, Editorial material (Övrigt vetenskapligt) Published
Ort, förlag, år, upplaga, sidor
W B SAUNDERS CO LTD, 2020
Nationell ämneskategori
Kirurgi
Identifikatorer
urn:nbn:se:uu:diva-403536 (URN)10.1016/j.ejvs.2019.12.002 (DOI)000506204700001 ()31924296 (PubMedID)
Tillgänglig från: 2020-01-30 Skapad: 2020-01-30 Senast uppdaterad: 2020-01-30Bibliografiskt granskad
Linder, F., Holmberg, L., Björck, M., Juhlin, C., Thorbjörnsen, K., Wisinger, J., . . . Mani, K. (2019). A prospective stepped wedge cohort evaluation of the new national trauma team activation criteria in Sweden - the TRAUMALERT study.. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 27(1), Article ID 52.
Öppna denna publikation i ny flik eller fönster >>A prospective stepped wedge cohort evaluation of the new national trauma team activation criteria in Sweden - the TRAUMALERT study.
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2019 (Engelska)Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 27, nr 1, artikel-id 52Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: Trauma triage based on prehospital information facilitates correct allocation of in-hospital resources. The Swedish national two-tier trauma team activation (TTA) criteria were revised in 2016. The current study aimed to evaluate the safety and efficacy of the new criteria.

METHODS: Five centres covering trauma care for 1.2 million inhabitants registered all trauma patients prospectively in the Swedish trauma registry (SweTrau) prior to and after stepwise introduction of new TTA criteria within the cohort (a prospective stepped-wedge cohort study design; period August 2016-November 2017). Evaluation of full- and limited-TTA frequency, under- and overtriage were performed at equal duration before and after this change.

RESULTS: The centres registered 1948 patients, 1882 (96.6%) of which were included in the study. With new criteria, frequency of full-TTA was unchanged, while limited-TTA decreased with 46.3% (from 988 to 531). 30-day trauma mortality was unchanged. The overtriage was 107/150 (71.3%) with former criteria, and 104/144 (72.2%) with new criteria, p = 0.866. Undertriage was 50/1037 (4.8%) versus 39/551 (7.1%), p = 0.063. Undertriage was consistently > 20% in patients with fall injury. Among patients with Injury Severity Score (ISS) > 15, 50/93 (53.8%) did not initiate full-TTA with former, vs 39/79 (49.4%) with new criteria, p = 0.565. Age > 60-years was a risk factor for undertriage (OR 2.89, p < 0.001), while low fall injuries indicated a trend (OR 2.70, p = 0.051).

CONCLUSIONS: The newly implemented Swedish TTA criteria result in a reduction in limited TTA frequency, indicating an increased efficiency in use of resources. The over- and undertriage is unchanged compared to former criteria, thus upholding patient safety.

Nyckelord
Epidemiology, Patient safety, Prospective stepped wedge cohort design, Trauma, Triage, Wounds and injuries
Nationell ämneskategori
Kirurgi
Identifikatorer
urn:nbn:se:uu:diva-383430 (URN)10.1186/s13049-019-0619-1 (DOI)000466508600002 ()31039800 (PubMedID)
Tillgänglig från: 2019-05-14 Skapad: 2019-05-14 Senast uppdaterad: 2019-11-21Bibliografiskt granskad
Grip, O., Wanhainen, A. & Björck, M. (2019). Acute Aortic Occlusion: Nationwide Cohort Study [Letter to the editor]. Circulation, 139(2), 292-294
Öppna denna publikation i ny flik eller fönster >>Acute Aortic Occlusion: Nationwide Cohort Study
2019 (Engelska)Ingår i: Circulation, ISSN 0009-7322, E-ISSN 1524-4539, Vol. 139, nr 2, s. 292-294Artikel i tidskrift, Letter (Refereegranskat) Published
Ort, förlag, år, upplaga, sidor
LIPPINCOTT WILLIAMS & WILKINS, 2019
Nyckelord
arterial occlusive diseases, embolism, graft occlusion, vascular, ischemia, thrombosis
Nationell ämneskategori
Kardiologi
Identifikatorer
urn:nbn:se:uu:diva-379086 (URN)10.1161/CIRCULATIONAHA.118.036420 (DOI)000459428700019 ()30615512 (PubMedID)
Tillgänglig från: 2019-03-12 Skapad: 2019-03-12 Senast uppdaterad: 2019-03-12Bibliografiskt granskad
Mani, K. & Björck, M. (2019). Alternatives to Randomised Controlled Trials for the Poor, the Impatient, and When Evaluating Emerging Technologies. European Journal of Vascular and Endovascular Surgery, 57(4), 598-599
Öppna denna publikation i ny flik eller fönster >>Alternatives to Randomised Controlled Trials for the Poor, the Impatient, and When Evaluating Emerging Technologies
2019 (Engelska)Ingår i: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 57, nr 4, s. 598-599Artikel i tidskrift, Editorial material (Övrigt vetenskapligt) Published
Ort, förlag, år, upplaga, sidor
W B SAUNDERS CO LTD, 2019
Nationell ämneskategori
Kirurgi
Identifikatorer
urn:nbn:se:uu:diva-383053 (URN)10.1016/j.ejvs.2018.10.026 (DOI)000464932200028 ()30509892 (PubMedID)
Tillgänglig från: 2019-05-08 Skapad: 2019-05-08 Senast uppdaterad: 2019-05-08Bibliografiskt granskad
Kaluza, J., Stackelberg, O., Harris, H. R., Björck, M. & Wolk, A. (2019). Anti-inflammatory diet and risk of abdominal aortic aneurysm in two Swedish cohorts. Heart, 105(24), 1876-1883
Öppna denna publikation i ny flik eller fönster >>Anti-inflammatory diet and risk of abdominal aortic aneurysm in two Swedish cohorts
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2019 (Engelska)Ingår i: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 105, nr 24, s. 1876-1883Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective The relationship between dietary patterns and development of abdominal aortic aneurysm (AAA) is not well understood. Thus, we prospectively evaluated the association between the anti-inflammatory potential of diet and risk of AAA. Methods The study population included the Cohort of Swedish Men (45 072 men) and the Swedish Mammography Cohort (36 633 women), aged 45-83 years at baseline. The anti-inflammatory potential of diet was estimated using Anti-inflammatory Diet Index (AIDI) based on 11 foods with anti-inflammatory potential and 5 with proinflammatory potential (maximum 16 points) that was validated againsthigh sensitivity C reactive protein (hsCRP). Cox proportional hazard regression models were used to estimate HRs and 95% CIs. During the 14.9 years of follow-up (1 217 263 person-years), 1528 AAA cases (277 (18%) ruptured, 1251 non-ruptured) were ascertained via the Swedish Inpatient Register, the National Cause of Death Register and the Register for Vascular Surgery (Swedvasc). Results We observed an inverse association between the AIDI and AAA risk in women and men; HRs between extreme quartiles of the AIDI (>= 8 vs <= 5 points) were 0.55 (95% CI 0.36 to 0.83) in women and 0.81 (95% CI 0.68 to 0.98) in men. The AIDI was inversely associated with both ruptured and non-ruptured AAA incidence; the HR of participants in the highest quartile of AIDI compared with those in the lowest quartile was 0.61 (95% CI 0.41 to 0.90) for ruptured AAA and 0.79 (95% CI 0.65 to 0.95) for non-ruptured AAA. Conclusion Adherence to diet with a high anti-inflammatory potential was associated with a reduced AAA risk, an association that was even more pronounced for AAA rupture.

Ort, förlag, år, upplaga, sidor
BMJ Publishing Group Ltd, 2019
Nationell ämneskategori
Kardiologi
Identifikatorer
urn:nbn:se:uu:diva-402390 (URN)10.1136/heartjnl-2019-315031 (DOI)000503800100008 ()31296589 (PubMedID)
Forskningsfinansiär
Vetenskapsrådet, VR 2015-02302Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, FORTE 2015-00778Forskningsrådet Formas, 2016-00308Vetenskapsrådet, 2017-00644
Tillgänglig från: 2020-01-24 Skapad: 2020-01-24 Senast uppdaterad: 2020-01-24Bibliografiskt granskad
Linder, F., Holmberg, L., Eklöf, H., Björck, M., Juhlin, C. & Mani, K. (2019). Better compliance with triage criteria in trauma would reduced costs with maintained patient safety. European journal of emergency medicine, 26(4), 283-288
Öppna denna publikation i ny flik eller fönster >>Better compliance with triage criteria in trauma would reduced costs with maintained patient safety
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2019 (Engelska)Ingår i: European journal of emergency medicine, ISSN 0969-9546, E-ISSN 1473-5695, Vol. 26, nr 4, s. 283-288Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVE: To evaluate trauma triage criteria in terms of compliance, undertriage, and overtriage and identify risk factors for mistriage.

METHODS: In a retrospective cohort study, all consecutive trauma patients at a University Hospital in Sweden in 2012 were included. Patients were stratified into three groups on the basis of trauma team activation (full trauma team, limited trauma team, and no trauma team). Case records were reviewed for mechanism of injury, vital signs, and injuries. Compliance with alert criteria was evaluated and injury severity score combined with the Matrix method was used for assessment of overtriage and undertriage.

RESULTS: A total of 1424 trauma patients were included in the study. Seventy-three (5.1%) patients activated a full trauma team, 732 (51.4%) a limited trauma team, and 619 (43.5%) did not activate any trauma team. Undertriage was 2.7% [95% confidence interval (CI): 1.9-3.8%] and overtriage was 34.2% (95% CI: 23.5-46.3%) in the complete cohort. Compliance with 'trauma triage criteria' was assessed by comparing actual alerts with what was estimated to be the correct alert levels on the basis of prehospital case records. Compliance with full trauma team criteria was 80% (68-88%), limited trauma team was 54% (51-58%), and no trauma team was 79% (76-82%). Assuming full compliance with trauma criteria, the Matrix method resulted in an undertriage of 2.3% (95% CI: 1.6-3.3%) and an overtriage of 42.6% (95% CI: 32.4-53.2%).

CONCLUSION: The overtriage and undertriage in this study is in line with the recommendations of the American College of Surgeons Committee on Trauma. However, better compliance with trauma alert criteria would result in fewer trauma team activations without affecting patient safety.

Nationell ämneskategori
Kirurgi
Identifikatorer
urn:nbn:se:uu:diva-383431 (URN)10.1097/MEJ.0000000000000544 (DOI)000480684900011 ()29438134 (PubMedID)
Tillgänglig från: 2019-05-14 Skapad: 2019-05-14 Senast uppdaterad: 2019-09-30Bibliografiskt granskad
Björck, M. (2019). Can we learn anything from the dinosaurs?. European Journal of Vascular and Endovascular Surgery, 57(3), 399-399
Öppna denna publikation i ny flik eller fönster >>Can we learn anything from the dinosaurs?
2019 (Engelska)Ingår i: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 57, nr 3, s. 399-399Artikel i tidskrift, Editorial material (Övrigt vetenskapligt) Published
Ort, förlag, år, upplaga, sidor
W B SAUNDERS CO LTD, 2019
Nationell ämneskategori
Kirurgi
Identifikatorer
urn:nbn:se:uu:diva-381526 (URN)10.1016/j.ejvs.2018.10.035 (DOI)000461902200015 ()30553581 (PubMedID)
Tillgänglig från: 2019-04-11 Skapad: 2019-04-11 Senast uppdaterad: 2019-04-11Bibliografiskt granskad
Ersryd, S., Gidlund, K. D., Wanhainen, A., Smith, L. & Björck, M. (2019). Editor's Choice - Abdominal Compartment Syndrome after Surgery for Abdominal Aortic Aneurysm: Subgroups, Risk Factors, and Outcome. European Journal of Vascular and Endovascular Surgery, 58(5), 671-679
Öppna denna publikation i ny flik eller fönster >>Editor's Choice - Abdominal Compartment Syndrome after Surgery for Abdominal Aortic Aneurysm: Subgroups, Risk Factors, and Outcome
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2019 (Engelska)Ingår i: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 58, nr 5, s. 671-679Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objectives: Abdominal compartment syndrome (ACS) is a serious complication after abdominal aortic aneurysm (AAA) repair. The aim was to investigate outcome among subgroups and factors associated with outcome, with emphasis on the duration of intra-abdominal hypertension before treatment.

Methods: Since 2008, ACS and decompressive laparotomy (DL) after AAA repair are registered prospectively in the Swedish vascular registry (Swedvasc). Registry data and case records were reviewed. Subgroups were defined by main pathophysiological finding at DL, timing of DL after AAA repair, and treatment modality.

Results: During 2008-2015, 120 of 8765 patients undergoing surgery for infrarenal AAA developed postoperative ACS (1.4%). Eighty-three followed ruptured AAA (rAAA); 45 open surgical repairs (OSR) and 38 endovascular (EVAR), and thirty-seven after intact AAA (iAAA); 30 OSR and seven EVAR. The main pathophysiological findings at DL were bowel ischaemia in 27 (23.3%), post-operative bleeding in 34 (29.3%), and general oedema in 55 (47.4%). DL was performed <24 hours after AAA repair in 56 (48.7%), 24-48 hours in 30 (26.1%), and >48 hours in 29 patients (25.2%). The overall 90 day mortality was 50.0%, neither different depending on main pathophysiological finding, nor on the timing of DL. In multivariable regression analysis, age was a predictor of mortality (p = .017), while duration of intra-abdominal hypertension (IAH) prior to DL predicted the need for renal replacement therapy (RRT) (p = .033). DL was performed earlier after EVAR compared with OSR in rAAA (p < .001).

Conclusions: Mortality in ACS was high, irrespective of the main pathophysiological finding and timing of DL. The duration of IAH prior to DL predicted the need for RRT. DL was performed earlier after EVAR than after OSR for rAAA, underlining the importance of monitoring IAP after EVAR for rAAA.

Ort, förlag, år, upplaga, sidor
W B SAUNDERS CO LTD, 2019
Nyckelord
Abdominal compartment syndrome, Aortic aneurysm-abdominal, Bowel ischaemia, Intra-abdominal pressure, Mortality, Renal replacement therapy
Nationell ämneskategori
Kirurgi
Identifikatorer
urn:nbn:se:uu:diva-397582 (URN)10.1016/j.ejvs.2019.04.007 (DOI)000493954400008 ()31405726 (PubMedID)
Tillgänglig från: 2019-11-25 Skapad: 2019-11-25 Senast uppdaterad: 2019-11-25Bibliografiskt granskad
Organisationer
Identifikatorer
ORCID-id: ORCID iD iconorcid.org/0000-0001-6561-9734

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