liu.seSearch for publications in DiVA
Change search
Link to record
Permanent link

Direct link
BETA
Sjöberg, Folke
Alternative names
Publications (10 of 208) Show all publications
Pompermaier, L., Elmasry, M., Abdelrahman, I., Fredrikson, M., Sjöberg, F. & Steinvall, I. (2018). Are there any differences in the provided burn care between men and women? A retrospective study. Burns & Trauma, 6, Article ID 22.
Open this publication in new window or tab >>Are there any differences in the provided burn care between men and women? A retrospective study
Show others...
2018 (English)In: Burns & Trauma, E-ISSN 2321-3876, Vol. 6, article id 22Article in journal (Refereed) Published
Abstract [en]

Background

Disparity between medical treatment for men and women has been recorded worldwide. However, it is difficult to find out if the disparities in both the use of resources and outcome depend entirely on sex-related discrimination. Our aim was to investigate if there are differences in burn treatments between the sexes.

Methods

All patients admitted with burns to Linköping University Hospital during the 16-year period 2000–2015 were included. Interventions were prospectively recorded using the validated Burn SCoring system (BSC). Data were analysed using a multivariable panel regression model adjusted for age, percentage total body surface area (%TBSA), and in-hospital mortality.

Results

A total of 1363 patients were included, who generated a total of 22,301 daily recordings while they were inpatients. Males were 70% (930/1363). Sex was not an independent factor for daily scores after adjustment for age, %TBSA, and mortality in hospital (model R2=0.60, p < 0.001).

Conclusion

We found no evidence of inequity between the sexes in treatments given in our burn centre when we had adjusted for size of burn, age, and mortality. BSC seems to be an appropriate model in which to evaluate sex-related differences in the delivery of treatments.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Burn care; Intervention score; Sex; Trauma model; Workload
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-150365 (URN)10.1186/s41038-018-0125-0 (DOI)000442159400001 ()30123802 (PubMedID)
Available from: 2018-08-20 Created: 2018-08-20 Last updated: 2018-09-10Bibliographically approved
Pompermaier, L., Steinvall, I., Elmasry, M., Thorfinn, J. & Sjöberg, F. (2018). Burned patients who die from causes other than the burn affect the model used to predict mortality: a national exploratory study. Burns, 44(2), 280-287
Open this publication in new window or tab >>Burned patients who die from causes other than the burn affect the model used to predict mortality: a national exploratory study
Show others...
2018 (English)In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 44, no 2, p. 280-287Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: The Baux score - the sum of age and total body surface area burned (TBSA %) - is a good predictor of mortality has a high specificity but low sensitivity. Our aim was to examine the causes of death in patients who die with Baux scores of <100, which may explain the lower sensitivity and possibly affect the prediction of mortality.

METHODS: All patients admitted to our centre for burn care from 1993 to 2015 (n=1946) were included in this retrospective, descriptive, exploratory study. The study group comprised those patients who died with Baux scores of <100 (n=23), and their medical charts were examined for the cause of death and for coexisting diseases.

RESULTS: Crude mortality was 5% (93/1946) for the overall cohort, and a quarter of the patients who died (23/93) had Baux scores of less than 100 (range 64-99). In this latter group, flame burns were the most common (18/23), the median (10th-90th centile) age was 70 (46-86) years and for TBSA 21 (5.0-40.5) %, of which 7 (0-27.0) % of the area was full thickness. The main causes of death in 17 of the 23 were classified as "other than burn", being cerebral disease (n=9), cardiovascular disease (n=6), and respiratory failure (n=2). Among the remaining six (burn-related) deaths, multiple organ failure (predominantly renal failure) was responsible. When we excluded the cases in which the cause of death was not related to the burn, the Baux mortality prediction value improved (receiver operating characteristics area under the curve, AUC) from 0.9733 (95% CI 0.9633-0.9834) to 0.9888 (95% CI 0.9839-0.9936) and the sensitivity estimate increased from 45.2% to 53.9%.

CONCLUSION: Patients with burns who died with a Baux score <100 were a quarter of all the patients who died. An important finding is that most of these deaths were caused by reasons other than the burn, usually cerebrovascular disease. This may be the explanation why the sensitivity of the Baux score is low, as factors other than age and TBSA % explain the fatal outcome.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Baux score, Burns, Cause of death, Mortality
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-142898 (URN)10.1016/j.burns.2017.07.014 (DOI)000427535000006 ()28830698 (PubMedID)2-s2.0-85027674409 (Scopus ID)
Note

Funding agencies: Burn Centre, Department of Plastic Surgery, Hand Surgery, and Burns, Region Ostergotland; Linkoping University, Linkoping, Sweden

Available from: 2017-11-09 Created: 2017-11-09 Last updated: 2018-04-12Bibliographically approved
Bäckström, D., Larsen, R., Steinvall, I., Fredrikson, M., Gedeborg, R. & Sjöberg, F. (2018). Deaths caused by injury among people of working age (18-64) are decreasing, while those among older people (64+) are increasing. European Journal of Trauma and Emergency Surgery, 44(4), 589-596
Open this publication in new window or tab >>Deaths caused by injury among people of working age (18-64) are decreasing, while those among older people (64+) are increasing
Show others...
2018 (English)In: European Journal of Trauma and Emergency Surgery, ISSN 1863-9933, E-ISSN 1863-9941, Vol. 44, no 4, p. 589-596Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Injury is an important cause of death in all age groups worldwide, and contributes to many losses of human and economic resources. Currently, we know a few data about mortality from injury, particularly among the working population. The aim of the present study was to examine death from injury over a period of 14 years (1999-2012) using the Swedish Cause of Death Registry (CDR) and the National Patient Registry, which have complete national coverage.

METHOD: CDR was used to identify injury-related deaths among adults (18 years or over) during the years 1999-2012. ICD-10 diagnoses from V01 to X39 were included. The significance of changes over time was analyzed by linear regression.

RESULTS: The incidence of prehospital death decreased significantly (coefficient -0.22, r (2) = 0.30; p = 0.041) during the study period, while that of deaths in hospital increased significantly (coefficient 0.20, r (2) = 0.75; p < 0.001). Mortality/100,000 person-years in the working age group (18-64 years) decreased significantly (coefficient -0.40, r (2) = 0.37; p = 0.020), mainly as a result of decrease in traffic-related deaths (coefficient -0.34, r (2) = 0.85; p < 0.001). The incidence of deaths from injury among elderly (65 years and older) patients increased because of the increase in falls (coefficient 1.71, r (2) = 0.84; p < 0.001) and poisoning (coefficient 0.13, r (2) = 0.69; p < 0.001).

CONCLUSION: The epidemiology of injury in Sweden has changed during recent years in that mortality from injury has declined in the working age group and increased among those people 64 years old and over.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Elderly, Injury, Mortality, Prehospital, Trauma, Working age
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-142763 (URN)10.1007/s00068-017-0827-1 (DOI)000440981100014 ()28825159 (PubMedID)2-s2.0-85027836250 (Scopus ID)
Available from: 2017-11-02 Created: 2017-11-02 Last updated: 2018-08-22Bibliographically approved
Abdelrahman, I., Steinvall, I., Mossaad, B., Sjöberg, F. & Elmasry, M. (2018). Evaluation of Glandular Liposculpture as a Single Treatment for Grades I and II Gynaecomastia. Aesthetic Plastic Surgery, 42(2), 1222-1230
Open this publication in new window or tab >>Evaluation of Glandular Liposculpture as a Single Treatment for Grades I and II Gynaecomastia
Show others...
2018 (English)In: Aesthetic Plastic Surgery, ISSN 0364-216X, E-ISSN 1432-5241, Vol. 42, no 2, p. 1222-1230Article in journal (Refereed) Published
Abstract [en]

Background

Gynaecomastia is a benign enlargement of the male breast, of which the psychological burden on the patient can be considerable, with the increased risk of disorders such as depression, anxiety, and social phobia. Minimal scarring can be achieved by liposuction alone, though it is known to have a limited effect on the dense glandular and fibroconnective tissues. We know of few studies published on “liposuction alone”, so we designed this study to evaluate the outcome of combining liposuction with glandular liposculpturing through two axillary incisions as a single treatment for the management of grades I and II gynaecomastia.

Methods

We made a retrospective analysis of 18 patients with grade I or II gynaecomastia who were operated on by combined liposuction and glandular liposculpturing using a fat disruptor cannula, without glandular excision, during the period 2014–2016. Patient satisfaction was assessed using the Breast Evaluation Questionnaire (BEQ), which is a 5-point Likert scale (1 = very dissatisfied; 2 = dissatisfied; 3 = neither; 4 = satisfied; 5 = very satisfied). The post-operative aesthetic appearance of the chest was evaluated by five independent observers on a scale from 1 to 5 (5 = considerable improvement).

Results

The patient mean (SD) overall satisfaction score was 4.7 (0.7), in which 92% of the responders were “satisfied” to “very satisfied”. The mean (SD) BEQ for all questions answered increased from 2.1 (0.2) “dissatisfied” preoperatively to 4.1 (0.2) “satisfied” post-operatively. The observers’ mean (SD) rate for the improvement in the shape of the front chest wall was 4.1 (0.7). No haematomas were recorded, one patient developed a wound infection, and two patients complained of remnants of tissue. The median (IQR) body mass index was 27.4 (26.7–29.4), 11 patients had gynaecomastia grade I, and 7 patients grade II. The median (IQR) volume of aspirated fat was 700 ml (650–800), operating time was 67 (65–75) minutes, 14 patients had general anaesthesia, and hospital charges were US$ 538 (481–594).

Conclusions

Combined liposuction and liposculpturing using the fat disruptor cannula resulted in satisfied patients and acceptable outcomes according to the observers’ ratings. It could be a useful alternative with an outcome that corresponds to that of more expensive methods.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Gynaecomastia, Liposculpture, Liposuction, Patient satisfaction
National Category
Surgery Gastroenterology and Hepatology Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:liu:diva-146046 (URN)10.1007/s00266-018-1118-x (DOI)000445156900007 ()29549405 (PubMedID)
Available from: 2018-03-23 Created: 2018-03-23 Last updated: 2018-10-08Bibliographically approved
Karlsson, M., Elmasry, M., Steinvall, I., Sjöberg, F., Olofsson, P. & Thorfinn, J. (2018). Scarring At Donor Sites After Split-Thickness Skin Graft: A Prospective, Longitudinal, Randomized Trial. Advances in Skin & Wound Care, 3(4), 183-188
Open this publication in new window or tab >>Scarring At Donor Sites After Split-Thickness Skin Graft: A Prospective, Longitudinal, Randomized Trial
Show others...
2018 (English)In: Advances in Skin & Wound Care, ISSN 1527-7941, E-ISSN 1538-8654, Vol. 3, no 4, p. 183-188Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The aim of this study was to evaluate scarring at split-thickness skin graft donor sites 8 years after surgery.

METHODS: At surgery, 67 patients were randomized to hydrofiber, polyurethane foam, or porcine xenograft treatment. Scars were evaluated with the Patient and Observer Scar Assessment Scale.

RESULTS: Results showed significant differences in observed scar outcomes at donor sites, leaving the polyurethane foam–treated and the porcine xenograft–treated patients with the least satisfying scars. Multivariable regression analysis showed that the group treated with the xenografts had worse scores for overall opinion of the scar than did the other groups (P = .03), the most important factor being pigmentation. There was no correlation between duration of healing time and quality of the scar.

CONCLUSIONS: There were significant differences among the groups, with the hydrofiber group being the most satisfied with the appearance of their scar.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2018
National Category
Surgery Otorhinolaryngology Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-146085 (URN)10.1097/01.ASW.0000530684.31491.5f (DOI)29561343 (PubMedID)
Available from: 2018-03-27 Created: 2018-03-27 Last updated: 2018-07-23Bibliographically approved
Bäckström, D., Steinvall, I. & Sjöberg, F. (2017). Change in child mortality patterns after injuries in Sweden: a nationwide 14-year study.. European Journal of Trauma and Emergency Surgery, 43(3), 343-349
Open this publication in new window or tab >>Change in child mortality patterns after injuries in Sweden: a nationwide 14-year study.
2017 (English)In: European Journal of Trauma and Emergency Surgery, ISSN 1863-9933, E-ISSN 1863-9941, Vol. 43, no 3, p. 343-349Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Sweden has one of the world's lowest child injury mortality rates, but injuries are still the leading cause of death among children. Child injury mortality in the country has been declining, but this decline seems to decrease recently. Our objective was therefore to further examine changes in the mortality of children's death from injury over time and to assess the contribution of various effects on mortality. The underlying hypothesis for this investigation is that the incidence of lethal injuries in children, still is decreasing and that this may be sex specific.

PATIENTS AND METHODS: We studied all deaths from injury in Sweden under-18-year-olds during the 14 years 1999-2012. We identified those aged under 18 whose underlying cause of death was recorded as International Classification of Diseases, 10th Revision (ICD-10) diagnosis from V01 to X39 in the Swedish cause of death, where all dead citizens are registered.

RESULTS: From the 1 January 1999 to 31 December 2012, 1213 children under the age of 18 died of injuries in Sweden. The incidence declined during this period (r = -0.606, p = 0.02) to 3.3 deaths/100,000 children-years (95 % CI 2.6-4.2). Death from unintentional injury was more common than that after intentional injury (p < 0.0001). There was a reduction in the incidence of unintentional injuries during the study period (r = -0.757, p = 0.03). The most common causes of death were injury to the brain (n = 337, 41 %), followed by drowning (n = 109, 13 %). The number of deaths after intentional injury increased (r = 0.585, p = 0.03) and at the end of the period was 1.5 deaths/100,000 children-years. The most common causes of death after intentional injuries were asphyxia (n = 177, 45 %), followed by injury to the brain (n = 76, 19 %).

DISCUSSION: Mortality patterns in injured children in Sweden have changed from being dominated by unintentional injuries to a more equal distribution between unintentional and intentional injuries as well as between sexes and the overall rate has declined further. These findings are important as they might contribute to the preventive work that is being done to further reduce mortality in injured children.

Place, publisher, year, edition, pages
Springer, 2017
Keywords
Children, Injury, Mortality, Scandinavia, Trauma
National Category
Other Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-135548 (URN)10.1007/s00068-016-0660-y (DOI)000402789500010 ()27084542 (PubMedID)
Note

Funding agencies: Swedish Carnegie Hero Fund

Available from: 2017-03-16 Created: 2017-03-16 Last updated: 2017-11-02Bibliographically approved
Abdelrahman, I., Elmasry, M., Olofsson, P., Steinvall, I., Fredrikson, M. & Sjöberg, F. (2017). Division of overall duration of stay into operative stay and postoperative stay improves the overall estimate as a measure of quality of outcome in burn care.. PLoS ONE, 12(3), Article ID e0174579.
Open this publication in new window or tab >>Division of overall duration of stay into operative stay and postoperative stay improves the overall estimate as a measure of quality of outcome in burn care.
Show others...
2017 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 3, article id e0174579Article in journal (Refereed) Published
Abstract [en]

Patients and Methods: Surgically managed burn patients admitted between 2010-14 were included. Operative stay was defined as the time from admission until the last operation, postoperative stay as the time from the last operation until discharge. The difference in variation was analysed with F-test. A retrospective review of medical records was done to explore reasons for extended postoperative stay. Multivariable regression was used to assess factors associated with operative stay and postoperative stay.less thanbr /greater thanResults: Operative stay/TBSA% showed less variation than total duration/TBSA% (F test = 2.38, pless than0.01). The size of the burn, and the number of operations, were the independent factors that influenced operative stay (R2 0.65). Except for the size of the burn other factors were associated with duration of postoperative stay: wound related, psychological and other medical causes, advanced medical support, and accommodation arrangements before discharge, of which the two last were the most important with an increase of (mean) 12 and 17 days (pless than0.001, R2 0.51).less thanbr /greater thanConclusion: Adjusted operative stay showed less variation than total hospital stay and thus can be considered a more accurate outcome measure for surgically managed burns. The size of burn and number of operations are the factors affecting this outcome measure.

Place, publisher, year, edition, pages
Public Library of Science, 2017
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-136275 (URN)10.1371/journal.pone.0174579 (DOI)000399175000022 ()
Note

Funding agencies: Burn Centre, Department of Plastic Surgery, Hand Surgery, and Burns; Linkoping University, Linkoping, Sweden

Available from: 2017-04-05 Created: 2017-04-05 Last updated: 2017-11-29
Abdelrahman, I., Elmasry, M., Steinvall, I., Fredrikson, M. & Sjöberg, F. (2017). Improvement in mortality at a National Burn Centre since 2000: Was it the result of increased resources?. Medicine (Baltimore, Md.), 96(25), Article ID e6727.
Open this publication in new window or tab >>Improvement in mortality at a National Burn Centre since 2000: Was it the result of increased resources?
Show others...
2017 (English)In: Medicine (Baltimore, Md.), ISSN 0025-7974, E-ISSN 1536-5964, Vol. 96, no 25, article id e6727Article in journal (Refereed) Published
Abstract [en]

Abstract The aim of this study was to find out whether the charging costs (calculated using interventional burn score) increased as mortality decreased. During the last 2 decades, mortality has declined significantly in the Linköping Burn Centre. The burn score that we use has been validated as a measure of workload and is used to calculate the charging costs of each burned patient. We compared the charging costs and mortality in 2 time periods (2000–2007 and 2008–2015). A total of 1363 admissions were included. We investigated the change in the burn score, as a surrogate for total costs per patient. Multivariable regression was used to analyze risk-adjusted mortality and burn score. The median total body surface area % (TBSA%) was 6.5% (10–90 centile 1.0–31.0), age 33 years (1.3–72.2), duration of stay/ TBSA% was 1.4 days (0.3–5.3), and 960 (70%) were males. Crude mortality declined from 7.5% in 2000–2007 to 3.4% in 2008–2015, whereas the cumulative burn score was not increased (P=.08). Regression analysis showed that risk-adjusted mortality decreased (odds ratio 0.42, P=.02), whereas the adjusted burn score did not change (P=.14, model R2 0.86). Mortality decreased but there was no increase in the daily use of resources as measured by the interventional burn score. The data suggest that the improvements in quality obtained have been achieved within present routines for care of patients (multidisciplinary/ orientated to patients’ safety).

Abbreviation: TBSA% = total body surface area %.

Place, publisher, year, edition, pages
Wolters Kluwer, 2017
Keywords
burn, cost, hospital billing charge, interventional score, mortality, resources, survival
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-138833 (URN)10.1097/md.0000000000006727 (DOI)000404116900001 ()28640072 (PubMedID)
Note

Funding agencies: Department of Plastic and Hand Surgery Linkoping University Hospital; Department of Clinical and Experimental Medicine, Linkoping University, Linkoping, Sweden

Available from: 2017-06-26 Created: 2017-06-26 Last updated: 2018-05-02
Abdelrahman, I. M., Elmasry, M., Steinvall, I. & Sjöberg, F. (2017). Response to comments on: A prospective randomized cost billing comparison of local fasciocutaneous perforator versus free Gracilis flap reconstruction for lower limb in a developing economy [Letter to the editor]. Journal of Plastic, Reconstructive & Aesthetic Surgery, 70(9), 1307-1308
Open this publication in new window or tab >>Response to comments on: A prospective randomized cost billing comparison of local fasciocutaneous perforator versus free Gracilis flap reconstruction for lower limb in a developing economy
2017 (English)In: Journal of Plastic, Reconstructive & Aesthetic Surgery, ISSN 1748-6815, E-ISSN 1532-1959, Vol. 70, no 9, p. 1307-1308Article in journal, Letter (Other academic) Published
Place, publisher, year, edition, pages
Elsevier, 2017
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-139724 (URN)10.1016/j.bjps.2017.06.014 (DOI)000410902100027 ()28688867 (PubMedID)2-s2.0-85021804889 (Scopus ID)
Available from: 2017-08-14 Created: 2017-08-14 Last updated: 2017-10-24Bibliographically approved
Wilhelms, S., Walther, S., Huss, F. & Sjöberg, F. (2017). Severe sepsis in the ICU is often missing in hospital discharge codes.. Acta Anaesthesiologica Scandinavica, 61(2)
Open this publication in new window or tab >>Severe sepsis in the ICU is often missing in hospital discharge codes.
2017 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 61, no 2Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Different International Classification of Diseases (ICD)-based code abstraction strategies have been used when studying the epidemiology of severe sepsis. The aim of this study was to compare three previously used ICD code abstraction strategies to the American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) consensus criteria for severe sepsis, in a setting of intensive care patients.

METHODS: All patients (≥ 18 years of age) with severe sepsis according to the ACCP/SCCM criteria registered in the Swedish Intensive Care Registry (2005-2009) were included in the study. Using the Swedish National Patient Register, we investigated whether these patients fulfilled an ICD code compilation for severe sepsis at hospital discharge.

RESULTS: Overall, 9271 patients with severe sepsis were registered in the Swedish Intensive Care Registry. A majority of these patients (55.4%) were discharged from the hospital with ICD codes that did not correspond to any of the ICD code compilations. A minority of patients (10.3%) were discharged with ICD codes corresponding to all three code abstraction strategies applied. Overall, the proportion of patients discharged with ICD codes corresponding to the criteria of Angus et al. was 15.1%, to the criteria of Flaatten was 39.8%, and to the criteria of Martin et al. was 16.0%.

CONCLUSIONS: A majority of patients with severe sepsis according to the ACCP/SCCM criteria were not discharged with ICD codes corresponding to the ICD code abstraction strategies; thus, the abstraction strategies did not identify the correct patients.

National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-133993 (URN)10.1111/aas.12814 (DOI)000394910200007 ()27699759 (PubMedID)
Note

Funding agencies: Region Ostergotland

Available from: 2017-01-17 Created: 2017-01-17 Last updated: 2018-05-03
Organisations

Search in DiVA

Show all publications