Search

Surgical quality registries: large room for improvement if they should be used for analyses of life style risk factors and the effect of preoperative initiatives on postoperative complications Tobacco, alcohol, malnutrition, overweight and physical inactivity increase postoperative morbidity. Preoperative intervention has been shown to improve the outcome significantly. The aim was to investigate if these lifestyle risk factors were reported in the Swedish national surgical quality registries together with preoperative interventions and postoperative complications. Altogether, 44 registers reporting on surgical procedures were identified. Preoperative documentation existed in about half of the registries, but relevant health promoting intervention was not documented. Postoperative complications were reported with varying degrees. No registry had complete reporting of preoperative lifestyle risk factors, related intervention and postoperative complications. For most registries, there is a large room for improvement if they should be used for analyses of risk factors and the effect of implementation of preoperative initiatives on postoperative complications.

This study examined whether alcohol screening identifies a larger percentage of patients with hazardous alcohol use compared with standard procedures at a surgical emergency unit. Patients were randomised into a study group, where a screening procedure was offered, and a control group, where standard procedures were followed. In the study group 20.9 per cent (using a conservative estimate, 14.8 per cent) of the patients screened positive for hazardous alcohol use, compared with 6.8 per cent in the control group. The screening procedure was particularly effective compared with normal routine in identifying hazardous alcohol use among young women.

In this study drinking habits among primary care patients were investigated as well as their views on discussing life style issues (eating habits, alcohol, smoking and exercise) with their physician. 13% of the men and 5% of the women reported high levels of alcohol consumption. 27% of the men and 11% of the women reported drinking five or more standard drinks more than two times per month. About 70% of the patients had never been questioned about any lifestyle item. A large majority judged lifestyle to be important for their health. 80-90% of all patients thought it important that lifestyle issues were discussed with patients, even if most patients did not perceive a need for this themselves. No differences in this regard were found between high and low consumers of alcohol.

Three different programs for individuals convicted of drunken driving are being evaluated in a randomized design in collaboration between researchers at the Karolinska Institute and the Prison and Probation Service in Sweden. In the years 1996-1998, 912 clients were interviewed by means of a structured interview, the Addiction Severity Index (ASI), which covers seven problem areas (medical status, alcohol use, employment status, drug use, legal status, family/social and psychiatric status). So far about half of the subjects have been re-investigated two years after leave. Initially, the group being investigated had problems particularly in the areas of criminality and alcohol use. Two years later a positive trend in most of the problem areas could be observed for clients in follow-up.