Baerum Hospital

Vestre, Norway

Baerum Hospital

Vestre, Norway
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Heiberg K.E.,Baerum Hospital | Heiberg K.E.,University of Oslo | Ekeland A.,Martina Hansens Hospital | Mengshoel A.M.,University of Oslo
BMC Musculoskeletal Disorders | Year: 2013

Background: In the field of rehabilitation, patients are supposed to be experts on their own lives, but the patient's own desires in this respect are often not reported. Our objectives were to describe the patients' desires regarding functional improvements before and after total hip arthroplasty (THA). Methods. Sixty-four patients, 34 women and 30 men, with a mean age of 65 years, were asked to describe in free text which physical functions they desired to improve. They were asked before surgery and at three and 12 months after surgery. Each response signified one desired improvement. The responses were coded according to the International Classification of Functioning, Disability and Health (ICF) to the 1§ssup§st§esup§, 2§ssup§nd§esup§ and 3§ssup§rd§esup§ category levels. The frequency of the codes was calculated as a percentage of the total number of responses of all assessments times and in percentage of each time of assessment. Results: A total of 333 responses were classified under Part 1 of the ICF, Functioning and Disability, and 88% of the responses fell into the Activities and Participation component. The numbers of responses classified into the Activities and Participation component were decreasing over time (p < 0.001). The categories of Walking (d450), Moving around (d455), and Recreation and leisure (d920) included more than half of the responses at all the assessment times. At three months after surgery, there was a trend that fewer responses were classified into the Recreation and leisure category, while more responses were classified into the category of Dressing (d540). Conclusions: The number of functional improvements desired by the patients decreased during the first postoperative year, while the content of the desires before and one year after THA were rather consistent over time and mainly concerned with the ability to walk and participate in recreation and leisure activities. At three months, however, there was a tendency that the patients were more concerned about the immediate problems with putting on socks and shoes. © 2013 Heiberg et al.; licensee BioMed Central Ltd.

Heiberg K.E.,University of Oslo | Heiberg K.E.,Baerum Hospital | Bruun-Olsen V.,University of Oslo | Ekeland A.,Martina Hansens Hospital | Mengshoel A.M.,University of Oslo
Arthritis Care and Research | Year: 2012

Objective. To investigate the effect of a 12-session walking skill training program of weight-bearing activities on physical functioning and self-efficacy initiated in patients 3 months after total hip arthroplasty (THA). Methods. Sixty-eight patients with THA, 35 women and 33 men, with a mean age of 66 years (95% confidence interval [95% CI] 64, 67 years), were randomized to a training group (n = 35) or a control group without physiotherapy (n = 33). Assessments were performed before the intervention at 3 months (pretest), at 5 months (posttest 1), and at 12 months (posttest 2) after surgery. The primary outcome was the 6-minute walk test (6MWT). The secondary outcomes were the stair climbing test (ST); figure-of-eight test; Index of Muscle Function (IMF); active hip range of motion (ROM) in flexion, extension, and abduction; Harris Hip Score (HHS); self-efficacy; and Hip Dysfunction and Osteoarthritis Outcome Score. Results. The training group had larger improvements than the control group at posttest 1 on the 6MWT with an adjusted mean difference of 52 meters (95% CI 29, 74 meters; P < 0.001) and on the ST of -1 second (95% CI -2, 0 seconds; P = 0.01).There were also improvements on the figure-of-eight test (P = 0.02), IMF (P = 0.001), active hip ROM in extension (P = 0.02), HHS (P = 0.05), and self-efficacy (P = 0.04). The difference between the groups persisted at posttest 2 on the 6MWT of 52 meters (95% CI 24, 80 meters; P < 0.001) and on the ST of -1 second (95% CI -3, 0 seconds; P = 0.05). Conclusion. The walking skill training program was effective, especially in improving walking both immediately after the intervention and 1 year after THA surgery. © 2012, American College of Rheumatology.

Heiberg K.E.,Baerum Hospital | Heiberg K.E.,University of Oslo | Ekeland A.,Martina Hansens Hospital | Bruun-Olsen V.,University of Oslo | Mengshoel A.M.,University of Oslo
Archives of Physical Medicine and Rehabilitation | Year: 2013

Objectives: To investigate recovery of physical functioning in patients during the first year after total hip arthroplasty (THA), and to predict postoperative walking distance outcomes from preoperative measures. Design: A longitudinal prospective design was used. Data were analyzed by repeated-measures analysis of variance and multivariate regression analyses. Setting: Two hospitals. Participants: Patients with hip osteoarthritis were consecutively included and assessed preoperatively (n=88), at 3 months (n=88), and at 12 months (n=64) after THA. Interventions: Not applicable. Main Outcome Measures: Physical functioning was assessed by objective measures - the 6-minute walk test (6MWT), stair climbing test, Index of Muscle Function, figure-of-eight, and active hip range of motion - and the subjective measures by Harris Hip Score and Hip dysfunction and Osteoarthritis Outcome Score. Results: In objective measures, improvements were found from preoperatively to 3 months in 6MWT (P<.01) and stair climbing test (P<.05) scores, while all measures had improved from 3 to 12 months (P≤.001). In contrast, all the subjective measures showed substantial improvements at 3 months, but small further improvements from 3 to 12 months (P<.001). Age, sex, preoperative 6MWT distance, and hip range of motion predicted 6MWT outcomes at 3 and 12 months (P≤.01). Conclusions: The objective measures of physical functioning improved gradually during the first postoperative year, while the subjective measures showed large early improvements, but little further improvements. Younger age, male sex, and better scores of walking distance and hip flexibility before surgery predicted better score in walking distance at both 3 and 12 months after surgery. © 2013 by the American Congress of Rehabilitation Medicine.

Langslet E.,Baerum Hospital | Langslet E.,University of Oslo | Frihagen F.,University of Oslo | Opland V.,Baerum Hospital | And 4 more authors.
Clinical Orthopaedics and Related Research | Year: 2014

Background: Displaced femoral neck fractures usually are treated with hemiarthroplasty. However, the degree to which the design of the implant used (cemented or uncemented) affects the outcome is not known and may be therapeutically important. Questions/purposes: In this randomized controlled trial, we sought to compare cemented with cementless fixation in bipolar hemiarthroplasties at 5 years in terms of (1) Harris hip scores; (2) femoral fractures; (3) overall health outcomes using the Barthel Index and EQ-5D scores; and (4) complications, reoperations, and mortality since our earlier report on this cohort at 1-year followup. Methods: We present followup at a median of 5 years after surgery (range, 56-65 months) from a randomized trial comparing a cemented hemiarthroplasty (112 hips) with an uncemented, hydroxyapatite-coated hemiarthroplasty (108 hips), both with a bipolar head. Results were previously reported at 1-year followup. Harris hip scores, Barthel Index, and EQ-5D scores were assessed by one research nurse and one orthopaedic surgeon. Complications and reoperations were determined by chart review and radiographs examined by three orthopaedic surgeons. Sixty patients (56%) had died in the cemented group and 63 (60%) in the uncemented group. Respectively, three and two patients (2.7% and 1.9%) were completely lost to followup. Results: Harris hip scores at 5 years were higher in the uncemented group than in the cemented group (86.2 versus 76.3; mean difference 9.9; 95% confidence interval [CI], 1.9-17.9). The prevalence of postoperative periprosthetic femoral fractures was 7.4% in the uncemented group and 0.9% in the cemented group (hazard ratio [HR], 9.3; 95% CI, 1.16-74.5). Barthel Index and EQ-5D scores were not different between the groups. Between 1 and 5 years, we found no additional infections or dislocations. The mortality rate was not different between the groups (HR, 1.2; 95% CI, 0.82-1.7). Conclusions: Both arthroplasties may be used with good medium-term results after displaced femoral neck fractures. The uncemented hemiarthroplasty may result in higher hip scores but appears to carry an unacceptably high risk of later femoral fractures. Level of Evidence: Level I, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. © 2013 The Association of Bone and Joint Surgeons®.

Andersen M.R.,Baerum Hospital | Frihagen F.,University of Oslo | Madsen J.E.,University of Oslo | Figved W.,Baerum Hospital
Injury | Year: 2015

Purpose The aim of this study was to determine the rate of complications after routine syndesmotic screw removal. Materials and methods All patients who underwent syndesmotic screw removal at our hospital between 2007 and 2012 were included in the study. Patient demographics, surgical characteristics, radiographic evaluation and complications were recorded from the patients' charts. Questionnaires were sent by postal mail to all patients, to measure patient satisfaction and pain (VAS scales). Results 161 patients were included in the trial. A wound infection was found in 8 (5%) patients. 3 were regarded as serious infections requiring hospitalisation and intravenous antibiotics, 2 of those required surgical revisions. 5 patients were treated by oral antibiotics. Staphylococcus aureus was identified as the causing organism in all (6/8) cases with a positive culture. The patients with postoperative infection reported more pain (5.3 vs. 2.3; p = 0.02) and were less satisfied (4.7 vs. 7.6; p = 0.014) with their ankle compared to those without infection (T-test for independent samples). Conclusion There were 5% wound infections after routine syndesmotic screw removal. Routine antibiotic prophylaxis effective against S. aureus should be administered when removing syndesmotic screws. In our institution we now use one single dose Cefalotin of 2 g intravenously 30-60 min before screw removal. © 2015 Elsevier Ltd. All rights reserved.

Mellin-Olsen J.,Baerum Hospital | Staender S.,Regional Hospital Maennedorf
Current Opinion in Anaesthesiology | Year: 2014

Purpose of review Four years after the launch of the Helsinki Declaration on Patient Safety in Anaesthesiology, it is of interest to assess its role in European and Global Patient Safety efforts. Recent findings The Declaration is widely supported, not only in Europe, but also has attracted much attention and support globally. In Europe, it represented a major step in European-wide patient safety networking and initiatives. The European Patient Safety Task Force, created jointly by the European Board of Anaesthesiology and the European Society of Anaesthesiology, has developed useful monitoring and introduction tools. A new Patient Safety Committee is being introduced, and this will facilitate current and future initiatives. Summary The launch of Helsinki Declaration of Patient Safety in Anaesthesiology in 2010 was a major step forward for patient safety initiatives in European and Global anesthesiology. Several steps have been taken in the 4 years that have passed, but the task needs continuous attention to ensure that every patient received the safest possible anesthesiology care. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Berild G.H.,Gynekologene Pa Kolbotn | Kulseng-Hanssen S.,Baerum Hospital
International Urogynecology Journal and Pelvic Floor Dysfunction | Year: 2012

Introduction and hypothesis The study seeks to determine whether a urinary cough and jump stress test is reproducible and whether there is a relationship between a stress test and a 24-h pad test and our subjective Stress Incontinence Index. Methods Multicenter prospective cohort study of women with subjective stress incontinence. Each patient completed a validated Stress and Urge Incontinence Questionnaire and a 24-h pad test and performed two standardized cough and jump stress tests. Results All 108 women were incontinent during both the first and second stress tests. There was a large variation in leakage and the leakage was significantly larger during stress test 2 than during stress test 1 (P<0.02). Correlations found between the stress test and the 24hour pad test and between the stress test and the Stress Incontinence Index were poor. Conclusion The cough and jump stress test is reproducible and able to document stress leakage. © The International Urogynecological Association 2012.

Corino V.D.A.,Polytechnic of Milan | Ulimoen S.R.,Baerum Hospital | Enger S.,Baerum Hospital | Mainardi L.T.,Polytechnic of Milan | And 2 more authors.
Journal of Cardiovascular Electrophysiology | Year: 2015

Heart Rate Variability and Irregularity During AF Introduction Irregularity measures have been suggested as risk indicators in patients with atrial fibrillation (AF); however, it is not known to what extent they are affected by commonly used rate-control drugs. We aimed at evaluating the effect of metoprolol, carvedilol, diltiazem, and verapamil on the variability and irregularity of the ventricular response in patients with permanent AF. Methods and Results Sixty patients with permanent AF were part of an investigator-blind cross-over study, comparing 4 rate-control drugs (diltiazem, verapamil, metoprolol, and carvedilol). We analyzed five 20-minute segments per patient: baseline and the 4 drug regimens. On every segment, heart rate (HR) variability and irregularity of RR series were computed. The variability was assessed as standard deviation, pNN20, pNN50, pNN80, and rMSSD. The irregularity was assessed by regularity index, approximate (ApEn), and sample entropy. A significantly lower HR was obtained with all drugs, the HR was lowest using the calcium channel blockers. All drugs increased the variability of ventricular response in respect to baseline (as an example, rMSSD: baseline 171 ± 47 milliseconds, carvedilol 229 ± 58 milliseconds; P < 0.05 vs. baseline, metoprolol 226 ± 66 milliseconds; P < 0.05 vs. baseline, verapamil 228 ± 84; P < 0.05 vs. baseline, diltiazem 256 ± 87 milliseconds; P < 0.05 vs. baseline and all other drugs). Only β-blockers significantly increased the irregularity of the RR series (as an example, ApEn: baseline 1.86 ± 0.13, carvedilol 1.92 ± 0.09; P < 0.05 vs. baseline, metoprolol 1.93 ± 0.08; P < 0.05 vs. baseline, verapamil 1.86 ± 0.22 ns, diltiazem 1.88 ± 0.16 ns). Conclusion Modification of AV node conduction by rate-control drugs increase RR variability, while only β-blockers affect irregularity. © 2014 Wiley Periodicals, Inc.

Mellin-Olsen J.,Baerum Hospital | Staender S.,Baerum Hospital | Whitaker D.K.,Baerum Hospital | Smith A.F.,Baerum Hospital
European Journal of Anaesthesiology | Year: 2010

Anaesthesiology, which includes anaesthesia, perioperative care, intensive care medicine, pain therapy and emergency medicine, has always participated in systematic attempts to improve patient safety. Anaesthesiologists have a unique, crossspecialty opportunity to influence the safety and quality of patient care. Past achievements have allowed our specialty a perception that it has become safe, but there should be no room for complacency when there is more to be done. Increasingly older and sicker patients, more complex surgical interventions, more pressure on throughput, new drugs and devices and simple chance all pose hazards in the work of anaesthesiologists. In response to this increasingly difficult and complex working environment, the European Board of Anaesthesiology (EBA), in cooperation with the European Society of Anaesthesiology (ESA), has produced a blueprint for patient safety in anaesthesiology. This document, to be known as the Helsinki Declaration on Patient Safety in Anaesthesiology, was endorsed by these two bodies together with the World Health Organization (WHO), the World Federation of Societies of Anaesthesiologists (WFSA), and the European Patients' Federation (EPF) at the Euroanaesthesia meeting in Helsinki in June 2010. The Declaration represents a shared European view of that which is worthy, achievable, and needed to improve patient safety in anaesthesiology in 2010. The Declaration recommends practical steps that all anaesthesiologists who are not already using them can successfully include in their own clinical practice. In parallel, EBA and ESA have launched a joint patient safety task-force in order to put these recommendations into practice. It is planned to review this Declaration document regularly. © 2010 Copyright European Society of Anaesthesiology.

Ofstad A.P.,Baerum Hospital
Scandinavian Journal of Clinical and Laboratory Investigation | Year: 2016

Type 2 diabetes mellitus (T2DM) is strongly associated with increased risk of myocardial dysfunction and cardiovascular disease (CVD), two separate conditions which often co-exist and influence each other’s course. The prevalence of myocardial dysfunction may be as high as 75% in T2DM populations but is often overlooked due to the initial asymptomatic nature of the disease, complicating co-morbidities such as coronary artery disease (CAD) and obesity, and the lack of consensus on diagnostic criteria. More sensitive echocardiographic applications are furthermore needed to improve detection of early subclinical changes in myocardial function which do not affect conventional echocardiographic parameters. The pathophysiology of the diabetic myocardial dysfunction is not fully elucidated, but involves hyperglycemia and high levels of free fatty acids. It evolves over several years and increases the risk of developing overt HF, and is suggested to at least in part account for the worse outcome seen in T2DM individuals after cardiac events. CAD and stroke are the most frequent CV manifestations among T2DM patients and relate to a large degree to the accelerated atherosclerosis driven by inflammation. Diagnosing CAD is challenging due to the lower sensitivity inherent in the diagnostic tests and there is thus a need for new biomarkers to improve prediction and detection of CAD. It seems that a multi-factorial approach (i.e. targeting several CV risk factors simultaneously) is superior to a strict glucose lowering strategy in reducing risk for macrovascular events, and recent research may even support an effect also on HF outcomes. © 2016 Taylor & Francis

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