[SPOR covers 100 percent of publicly run surgical care]. / SPOR ­ täckande data om över 5 miljoner ingrepp.

The Swedish Perioperative Register (SPOR) - a national quality register - supports automatic data transfer from local medical records to its central database, without the need for further manual input. Covering 100 percent of surgical operations across all publicly run hospitals in Sweden, SPOR data show regional inequality regarding patients' waiting time from the decision to operate until the start of surgery. SPOR data can inform several areas of improvement for perioperative care, such as management of postoperative pain and nausea, increased use of the Checklist for Safe Surgery, and improved logistics. The growing number of online reports downloaded locally suggests increasing use of SPOR data for follow-up and care improvement efforts. Data from many privately run surgical units do not appear in the SPOR due to technical difficulties in reporting.

The clinical noncompliance of oral sotalol/magnesium for prophylactic treatment of atrial fibrillation after coronary artery bypass grafting.

BACKGROUND: Postoperative atrial fibrillation has been refractory to many attempted pharmacologic prevention methods and, when effective, side effects have been described. The present aim was to study the clinical compliance of a suggested prophylactic treatment, oral sotalol, and magnesium. METHODS: Coronary-bypass patients without clinical contraindications to receive oral sotalol (80 mg twice daily) and magnesium supplementation were enrolled (n = 49) with an intention-to-treat strategy and being compared with a matched control group (n = 844). A protocol listed exclusion criteria of clinical compliance that was postoperatively evaluated prior to and during treatment. RESULTS: Twenty-seven of the 49 enrolled patients (55%) were compliant to sustain the treatment according to the protocol. The remaining patients were postoperatively excluded, mainly because of hemodynamic reasons, of whom 14 were noncompliant to initiate any treatment. The AF occurrence in the compliant group was 7% versus 36% in noncompliant patients (p = 0.035), and 24% in the control group (p = 0.076). However, with an intention-to-treat policy the overall AF incidence became 18%. The subgroups of enrolled patients demonstrated skewing phenomena. The noncompliant group had higher requirement for inotropic support (p = 0.029) and longer aortic cross-clamp time (p = 0.048) compared to compliant patients. Further, the body weight of noncompliant patients was markedly lower than in the compliant counterpart (p = 0.015). CONCLUSIONS: The tested treatment protocol showed limited compliance among routine cardiac-surgery patients, and further, introduced a biased selection of patients that skewed the results and may have partly explained the treatment effect.