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B Brorsson

Publications and source records attributed to B Brorsson.

At least 37 records · Page 2Linked to original sources
PubMed1997

Waiting for coronary revascularization: a comparison between New York State, The Netherlands and Sweden.

OBJECTIVE: To compare waiting times for percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass graft (CABG) surgery in New York State, the Netherlands and Sweden and to determine whether queuing adversely affects patients' health. METHODS: We reviewed the medical records of 4487 chronic stable angina patients who underwent PTCA or CABG in one of 15 New York State hospitals (n = 1021) or were referred for PTCA or CABG to one of ten hospitals in the Netherlands (n = 1980) or to one of seven hospitals in Sweden (n = 1486). We measured the median waiting time between coronary angiography and PTCA or CABG. RESULTS: The median waiting time for PTCA in New York was 13 days compared with 35 and 42 days, respectively, in the Netherlands and Sweden (P < 0.001). For CABG, New York patients waited 17 days, while Dutch and Swedish patients waited 72 and 59 days, respectively (P < 0.001). The Swedish and Dutch waiting list mortality rate was 0.8% for CABG candidates and 0.15% for PTCA candidates. CONCLUSIONS: There were large variations in waiting time for coronary revascularization among these three sites. Patients waiting for CABG were at greatest risk of experiencing an adverse event. In both the Netherlands and Sweden, the capacity to perform coronary revascularization has been expanded since this study began. Further international cooperation may identify other areas where quality of care can be improved.

Angina Pectoris↗
PubMed1997

CABG in chronic stable angina pectoris patients: indications and outcomes (SECOR/SBU). Swedish Societies for Cardiology, Thoracic Radiology and Thoracic surgery/Swedish Council for Technology Assessment in Health Care.

OBJECTIVE: In order to ascertain the reasons why coronary revascularisation is performed, the appropriateness of these procedures and their outcomes, a national collaborative study encompassing 7 of 8 hospitals performing CABG in Sweden was undertaken. This article presents the indications and outcomes in the largest intervention group, chronic stable angina pectoris treated by first time CABG. METHODS: A prospective multi-centre study was carried out during a 3.5 month period in each centre. Patients (1039) with chronic stable angina pectoris undergoing first time CABG were enrolled. Patients' quality of life was recorded at the time they underwent angiography and again 6 months post-operatively. Mortality and serious peri-and post-operative complications were recorded. The study was designed and carried out by an independent government agency, the Swedish Council for Technology Assessment in Health Care (SBU) with a project group of representatives for the Swedish Societies for Cardiology, Thoracic Radiology and Thoracic Surgery. RESULTS: Median age was 66 years. A total of 80% were males. The mortality rates at 30 days and 6 months were 1.0 and 1.9%, respectively. A balloon pump was used for 0.9% of patients and 1.4% of them were on a respirator for more than 24 h. At recruitment, 43.9% of the patients reported having severe angina (CCS II/IV), 70.1% had angina > or = 3 times per week, and 53.1% used sublingual nitrates > or = 3 times per week. The corresponding results at 6 months were 6.7, 10.5 and 3.3%, respectively. Patient satisfaction with operative treatment was high. In comparison with the pre-operative status, quality of life was markedly improved after surgery. CONCLUSION: This study shows that CABG in chronic stable angina pectoris yields good outcomes with a low mortality and morbidity and a high degree of patient satisfaction and quality of life.

Adult↗
PubMed1997

The effect of dissemination of recommendations on use. Preoperative routines in Sweden, 1989-91.

The purpose of this study was to monitor changes in preoperative routines following recommendations given in 1989 by the Swedish Council on Technology Assessment and by the Swedish Consensus Conference on Preoperative Routines, both suggesting a more individualized utilization of preoperative testing. This was a multicenter, prospective, repetitive study conducted at seven Swedish hospitals providing surgical care. The subjects included all patients presenting at the operating theaters for surgical interventions requiring general or regional anesthesia. The main outcome measures were the frequency of reports of performed preoperative ECG, chest x-ray, and analysis of serum concentration of potassium. Before general recommendations were issued in 1989, 47% of the patients had had a preoperative ECG, 26% had had a chest x-ray, and in 61% serum potassium concentration had been measured. In 1991 these frequencies had been reduced by 5, 6, and 9 percentage points, respectively (all figures given standardized for age and sex). Large differences were found between individual hospitals. Although recommendations suggesting a more restrictive and individualized utilization of preoperative testing have sparked important revisions in Swedish hospitals, there seems to be substantial potential remaining for further reduction of perfunctory use of preoperative screening.

Adolescent↗
PubMed1997

Quality of life among patients with glaucoma in Sweden.

PURPOSE: To assess the health-related quality of life (HRQOL) in an unselected sample of patients with glaucoma. METHODS: The HRQOL was studied in a cross-sectional survey in 270 patients from two departments of ophthalmology in different parts of Sweden by using the Swedish Health-Related Quality of Life Survey, a generic HRQOL-instrument adapted from the Medical Outcomes Study. RESULTS: Compared to a random Standard Population Sample, the glaucoma patients showed lower mean score only in the scale of 'Pain' (p < 0.05, effect size 0.17), but higher mean score in 'Sexual functioning' (p < 0.01, effect size 0.35). Significant factors correlated to a lower score on HRQOL-scales were decreased visual acuity and visual field, and comorbidity of cardiovascular and non-vascular systemic diseases. Regarding the topical medications, beta-blockers with or without miotic agents had no negative impact on the HRQOL. CONCLUSION: Our findings indicate that health-related quality of life in glaucoma patients in general is good, especially when vision is intact, and that topical beta-blockers do not have any negative influence.

Aged↗
PubMed1997

Psychic and socioeconomic consequences with diabetes compared to other chronic conditions.

The present study relies on data for the years 1988 and 1989 from the Swedish continuous Surveys of Living Conditions (SLC), which are based on random samples from the population among individuals aged 16 through 84 years. We compared the rates of self-reported mental health for subjects reporting diabetes (n = 361), a musculoskeletal condition but without diabetes (n = 2187), hypertension but without diabetes (n = 980), and healthy free from any medical condition (n = 6664). Comparisons are based on age- and gender-standardized rates, using the diabetes group as standard. The results show that more diabetic respondents had psychic symptoms and long-standing psychiatric disorders than the healthy respondents, with otherwise no differences compared to the other chronic conditions. The diabetic respondents had lower mean disposable income, and a higher rate of disability pension than the respondents with hypertension, and than the healthy. They also reported more sick leave days than the healthy respondents.

Adolescent↗
PubMed1997

Quality of life in diabetic patients registered with primary health care services in Sweden.

OBJECTIVE: To evaluate the health-related quality of life in diabetic subjects in primary health care. DESIGN: A cross-sectional, questionnaire survey of diabetic patients registered with primary health services, compared with a standard population sample. SETTING: Three community health centres in the Metropolitan Stockholm area. SUBJECTS: 341 diabetic individuals aged 21-84 years, with 229 respondents, i.e. 67%. Matched controls of the same age and sex from a standard population sample of 2366 individuals. MAIN OUTCOME MEASURES: Quality of life was assessed by the Swedish Health-Related Quality of Life Survey (SWEDQUAL), adopted from the Medical Outcomes Study and consisting of 61 items covering aspects of physical, mental, social, and general health. Medical data were extracted from the medical records. RESULTS: Diabetic patients had significantly lower scores on all scales (p < 0.001 for ten, and p < 0.01 for one), except for social health, when compared with the standard population sample. Outcomes were correlated with vascular and non-vascular comorbidity, age, and income, but not with level of metabolic control. CONCLUSIONS: Diabetic patients in primary health care have a markedly lower health-related quality of life, compared with a standard population.

Adult↗
PubMed1996

Drug use in patients with diabetes.

OBJECTIVE: To describe the use of pharmaceutical medications by patients with diabetes in Sweden. RESEARCH DESIGN AND METHODS: We analyzed the computerized Surveys of Living Conditions (SLC), performed regularly in Sweden, for the years 1988 and 1989, among individuals aged 16-84 years. Drug use (during a 2-week period) and the use of health services (during a 3-month period) were registered for subjects with diabetes (n = 361) and compared with age- and gender-standardized figures (using the diabetes group as the standard) in subjects with hypertension but without diabetes (n = 980), in subjects with a musculoskeletal condition but without diabetes (n = 2,187), in healthy subjects free from any medical condition (n = 6,664), and in the general population sample (n = 12,717). RESULTS: The reported use of medication was higher for subjects with diabetes compared with the general population regarding overall use (92.5 vs. 71.9%; P < 0.001), the use of cardiovascular drugs (52.2 vs. 36.3%; P < 0.001), all use of analgesics (43.8 vs. 36.5%; P < 0.05), and use of psychoactive drugs (23.5 vs. 15.3%; P < 0.01). Compared with the hypertension group, the use was lower regarding cardiovascular drugs (52.2 vs. 93.3%; P < 0.001), and compared with the musculoskeletal group, the use was lower regarding all use of analgesics (43.8 vs. 56.5%; P < 0.01) and the use of herbal products (6.8 vs. 11.8%; P < 0.05), but was higher regarding cardiovascular drugs (52.2 vs. 37.8%; P < 0.001). The use was higher compared with the healthy individuals, regarding all groups of drugs with the exception of vitamins and herbal products. CONCLUSIONS: Diabetic subjects have a higher overall use of drugs compared with the general population. Compared with other chronic illnesses, the differences are small except for disease-specific drugs (cardiovascular drugs in the hypertension group and analgesics in the musculoskeletal group). The main difference concerns the comparison with healthy subjects who had a markedly higher drug rate among diabetic subjects, thus signifying a greater impact on health.

Adolescent↗
PubMed1993

The Swedish Health-Related Quality of Life Survey (SWED-QUAL).

We present a Swedish Health-Related Quality of Life Survey (SWED-QUAL) that was adapted from measures used in the Medical Outcome Study (MOS). The development of these measures spans more than 20 years and their reliability and validity have been extensively tested. The SWED-QUAL consists of 61 items that form 11 multi-item scales tapping aspects of physical, mental, social and general health. The instrument was mailed in 1991 to a random stratified sample of 2,366 individuals from the Swedish general population aged 18-84 years and to a stratified random sample of 2,349 individuals who had been seriously injured in a traffic accident. The response rates were 61% and 59%, respectively. Telephone follow-up of non-responders indicate that most of those tended to have a better health-related quality of life than responders. The SWED-QUAL satisfied all of the psychometric criteria that were evaluated. Multitrait scaling provided strong support for item discrimination. Cronbach's alpha exceeded 0.78 for all scales. Scores tended to be lower among older than younger people, and among females compared to males. The good response rate indicates that the content of the SWED-QUAL is considered relevant by people at large, that the results from the general population sample could be used for comparisons with other samples and the instrument used for further studies of the effectiveness of a broad spectrum of medical interventions.

Adolescent↗
PubMed1990

Facing AIDS: reactions among police officers, nurses and the general public in Sweden.

This study compares police officers and registered nurses and the general public concerning their perceptions of the risk of HIV infection, attitudes toward HIV-infected individuals, and attitudes toward measures used to fight the AIDS epidemic. Information was obtained through mail questionnaires sent to random samples of individuals, aged 25-44 years, from the 3 groups. The samples included 525, 501 and 1600 individuals respectively. Response rates were 85, 93 and 74%. The study showed good knowledge concerning verified carriers of HIV infection (blood, sperm, vaginal secretion, etc.). A widespread fear of unverified carriers of infection (public toilets, kissing on the mouth) existed particularly among the public and police officers. Negative attitudes toward HIV-infected individuals and demands for compulsory measures were common among all groups, although least common among nurses and most common among the police. Positive relationships were established between the fear of unverified carriers of infection, repulsive attitudes toward individuals infected by HIV, and demands for compulsory measures.

Acquired Immunodeficiency Syndrome↗
PubMed1990

AIDS in the minds of Swedish people: 1986-1989.

In order to assess changes in knowledge, attitudes and behaviour related to AIDS, annual mail surveys (1986-1989) were sent to random samples of the general public, aged 16-44 years. In total, 16,900 individuals were sampled, with an average response rate of 71%. Knowledge about the major routes of infection was generally good during the entire study period. The fear of unverified infection risks and of contact with HIV-infected people decreased during the period studied, but still remained high in 1989. Over the entire period, respondents expressed a strong fear concerning the spread of HIV in the population. Although an increasing percentage of respondents reported altered sexual habits as a result of fear of AIDS, overall sexual behaviour did not change sufficiently to reduce the risk of spread of any sexually transmissible disease. Progress toward knowledge, attitudes, and behaviour aimed at prevention of transmission of infection and unnecessary fear and counteraction of prejudice was most rapid during the middle of the study period when public debate concerning AIDS was at its peak. Knowledge and attitudes did not change during the last year of the study, but, in some respects, reverted to previous levels.

Acquired Immunodeficiency Syndrome↗