Translation and validation of the Norwegian version of the postoperative quality of recovery score QoR-15.

BACKGROUND: As patient-centered care gains more attention, assessing the patient's perspective on their recovery has become increasingly important. In response to the need for a reliable and valid patient reported outcome measurement tool for major surgical resections in Norway. The Norwegian Registry for Gastrointestinal Surgery (NORGAST) initiated a project to translate and evaluate QoR-15's psychometric properties for patients going through general, gastrointestinal (GI), and hepato-pancreato-biliary (HPB) resectional surgery. METHODS: After a translation and adaption of the original version of QoR-15 into Norwegian, the QoR-15NO was psychometrically evaluated including a confirmatory factor analysis to test for unidimensionality, as well as tests for content validity, internal consistency, measurement error, construct validity, feasibility, and responsiveness. This process included cognitive interviews using a structured interview guide. Further, patients who underwent various types of GI/HPB surgery at five hospitals in different parts of Norway completed the QoR-15NO before surgery and on the first or second day after surgery. The impact of surgery was classified according to Surgical Outcome Risk Tool v2 (SORT), in extra major/complex, major, intermediate, and minor. RESULTS: This study included 324 patients with 83% return rate with both pre- and postoperative forms. There were negative correlations between duration of surgery and postoperative QoR-15 score and the difference between post- and preoperative score (change score). Individuals who had gone through surgery with major impact had a lower postoperative mean QoR-15 score (97) than their counterparts who had experienced either medium (QoR-15: 110) or minor (QoR15: 119) impact surgery. Cronbach's alpha (0.88) and Omega Alpha Total (ωt = 0.90) indicate that the scale has good to very good internal consistency. Test-retest reliability was measured by Intra-class Correlation Coefficient to ICC = 0.70. Confirmatory factor analyses supported that a one-factor model with correlated residuals had a good fit to data. CONCLUSION: This study supports QoR-15NO as a valid, essentially unidimensional, feasible, and responsive instrument among patients undergoing general, GI, and HPB resectional surgery in Norway. The total QoR-15NO score provides important information that can be used in an everyday clinical setting and integrated into NORGAST.

Sports injuries and illnesses in the Lillehammer 2016 Youth Olympic Winter Games.

BACKGROUND: Injury and illness surveillance during high-level youth sports events is an important first step in health prevention and caretaking of the young elite athletes. AIM: To analyse injuries and illnesses that occurred during the 10 days 2nd Youth Olympic Winter Games (YOG), held in Lillehammer 2016. METHODS: We recorded the daily occurrence (or non-occurrence) of injuries and illnesses through the reporting of (1) all National Olympic Committee (NOC) medical teams and (2) the polyclinic and medical venues by the Lillehammer Organising Committee (LYOCOG) medical staff. RESULTS: In total, 1083 athletes (48 double-starters), 46% (n=502) of them females, from 70 NOCs were registered in the study. NOCs and LYOCOG reported 108 injuries and 81 illnesses, equalling to 9.5 injuries and 7.2 illnesses per 100 athletes. The percentage of injured athletes was highest in the snowboard and ski slopestyle and cross disciplines, alpine skiing and skeleton, and lowest in the Nordic skiing disciplines. Approximately, two-thirds of the injuries (n=71, 65.7%) prevented the athlete from training or competition, while 10 injuries (9.3%) were registered with an estimated absence from sport for >7 days. The rate of illness was highest in curling and the Nordic skiing disciplines with most of them being respiratory tract infections (81.5%). CONCLUSIONS: Overall, 9% of the athletes incurred at least one injury during the games, and 7% an illness, which is similar to the first YOG in Innsbruck 2012 and slightly lower compared with previous Winter Olympic Games. The incidence of injuries and illnesses varied substantially between sports.

Transcatheter arterial embolization in the management of bleeding duodenal ulcers: a 5.5-year retrospective study of treatment and outcome.

OBJECTIVE: The mortality rate associated with bleeding duodenal ulcer disease is about 10%. Primary endoscopic hemostasis is successful in over 90% of patients, but in 15-25%, the bleeding cannot be controlled endoscopically or the patient rebleeding, requiring alternative treatment. Percutaneous transcatheter arterial embolization (TAE) has been proposed as an alternative to surgery and was introduced at Ullevål University Hospital in Oslo, Norway, in June 2000. In this study we report our experiences in 36 patients. MATERIAL AND METHODS: A retrospective review identified all patients admitted to Ullevål University Hospital with hematemesis and/or melena and endoscopically verified duodenal ulcer from June 2000 to 2005. The indication for TAE was endoscopically unmanageable bleeding/rebleeding or rebleeding after surgery. Technical success was defined as acute hemostasis. Clinical success was defined as technical success without rebleeding within 30 days. RESULTS: A total of 278 patients (mean age 73 years) were included in the study. Primary endoscopic hemostasis failed in 13 patients (5%) and 53 patients (20%) experienced rebleeding. An attempt was made to treat 36 patients with TAE. Technical success in the TAE group was 92% and clinical success was 72%. In total, 10 patients underwent surgery, 3 because of rebleeding after TAE. The 30-day mortality was 10% for all patients, 19% in the TAE group, and 20% in the surgical group. CONCLUSIONS: High technical and clinical success was obtained with TAE in patients with bleeding duodenal ulcer after failure of endoscopic treatment. TAE appears to be a treatment alternative to surgery in this group of patients.