The Danish Vascular Registry, Karbase.

AIM: The Danish Vascular Registry (DVR), Karbase, is monitoring arterial and advanced vein interventions conducted at all vascular departments in Denmark. The main aim of the DVR is to improve the quality of treatment for patients undergoing vascular surgery in Denmark by using the registry for quality assessment and research. STUDY POPULATION: All patients undergoing vascular interventions (surgical and endovascular) at any vascular department in Denmark are registered in the DVR. The DVR was initiated in 1989, and each year, ∼9,000 procedures are added. By January 2016, >180,000 procedures have been recorded. Since 2001, data completeness has been >90% (compared to the Danish National Patient Register). MAIN VARIABLES: Variables include information on descriptive patient data (ie, age, sex, height, and weight) and comorbidity (ie, previous cardiovascular disease and diabetes). Process variable includes waiting time (time from event to medical contact and treatment) and the type of procedures conducted. Outcome variables for in-hospital complications (ie, wound complications, myocardial infarction, stroke, amputation, respiratory complications, and renal insufficiency) and 30-day patency are submitted. Variables for medical treatment (antithrombotic and statin treatment), amputation, and survival are extracted from nationwide, administrative registers. CONCLUSION: The DVR reports outcome on key indicators for monitoring the quality at all vascular departments in Denmark for the purpose of quality improvement. Furthermore, data are available for research and are being used in international collaborations on changes in clinical practices.

[Carotid endarterectomy. Experiences with shortening of interval between symptom and operation]. / Subakut carotisendarterektomi. Erfaringer med afkortning af tidsrummet mellem symptom og operation.

INTRODUCTION: Carotid endarterectomy (CEA) prevents transient ischemic attack and stroke in patients with symptomatic high-grade carotid stenosis. In 2004 Rothwell et al showed that maximal benefit is gained if CEA is performed less than three weeks after the onset of the symptom. With the aim of observing this recommendation, in 2005 the Department of Vascular Surgery, Gentofte Hospital, introduced an accelerated course of examinations, a fast track, prior to CEA. MATERIALS AND METHODS: A retrospective study of the course of all patients operated with CEA during the period from June 2003 through September 2006. RESULTS: A total of 147 CEAs were performed on 145 patients, 51 before and 96 after the introduction of fast track. The period between the first symptom and CEA was reduced after the introduction of fast track to 31 days. It was easiest to reduce the time up to CEA in our own department and in the neurological departments. The stroke and death rate was unchanged, 4% and 3% before and after fast track respectively. CONCLUSION: The time between symptom and CEA can be shortened by means of a fast track after thorough information and reorganization of the work involving these patients. In order to bring the length of the period below the recommended three weeks, initiatives must be taken especially among specialist outside hospitals and among departments of general internal medicine.