{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:39:27Z","timestamp":1790948367551,"version":"4.1.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2013,1,3]],"date-time":"2013-01-03T00:00:00Z","timestamp":1357171200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,2,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Mortality and morbidity are considerable after treatment for perforated peptic ulcer (PPU). Since 2003, a Danish nationwide quality-of-care (QOC) improvement initiative has focused on reducing preoperative delay, and improving perioperative monitoring and care for patients with PPU. The present study reports the results of this initiative.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a nationwide cohort study based on prospectively collected data, involving all hospitals caring for patients with PPU in Denmark. Details of patients treated surgically for PPU between September 2004 and August 2011 were reported to the Danish Clinical Register of Emergency Surgery. Changes in baseline patient characteristics and in seven QOC indicators are presented, including relative risks (RRs) for achievement of the indicators.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The study included 2989 patients. An increasing number fulfilled the following four QOC indicators in 2010\u20132011 compared with the first 2 years of monitoring: preoperative delay no more than 6 h (59\u00b70 versus 54\u00b70 per cent; P = 0\u00b7030), daily monitoring of bodyweight (48\u00b70 versus 29\u00b70 per cent; P &amp;lt; 0\u00b7001), daily monitoring of fluid balance (79\u00b70 versus 74\u00b70 per cent; P = 0\u00b7010) and daily monitoring of vital signs (80\u00b70 versus 68\u00b70 per cent; P &amp;lt; 0\u00b7001). A lower proportion of patients had discontinuation of routine prophylactic antibiotics (82\u00b70 versus 90\u00b70 per cent; P &amp;lt; 0\u00b7001). Adjusted 30-day mortality decreased non-significantly from 2005\u20132006 to 2010\u20132011 (adjusted RR 0\u00b787, 95 per cent confidence interval 0\u00b776 to 1\u00b700), whereas the rate of reoperative surgery remained unchanged (adjusted RR 0\u00b798, 0\u00b778 to 1\u00b723).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This nationwide quality improvement initiative was associated with reduced preoperative delay and improved perioperative monitoring in patients with PPU. A non-significant improvement was seen in 30-day mortality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.9028","type":"journal-article","created":{"date-parts":[[2013,1,3]],"date-time":"2013-01-03T07:16:52Z","timestamp":1357197412000},"page":"543-552","source":"Crossref","is-referenced-by-count":45,"title":["Quality-of-care initiative in patients treated surgically for perforated peptic ulcer"],"prefix":"10.1093","volume":"100","author":[{"name":"Danish Clinical Register of Emergency Surgery","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M H","family":"M\u00f8ller","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine, Copenhagen University Hospital Rigshospitalet, and Departments of Gastrointestinal Surgery, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H J","family":"Larsson","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Rosenstock","sequence":"additional","affiliation":[{"name":"Copenhagen University Hospital Hvidovre, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"J\u00f8rgensen","sequence":"additional","affiliation":[{"name":"Copenhagen University Hospital Herlev, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S P","family":"Johnsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A H","family":"Madsen","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Regional Hospital Herning, Herning, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Adamsen","sequence":"additional","affiliation":[{"name":"Copenhagen University Hospital K\u00f8ge, Copenhagen, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A G","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine, Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Zimmermann-Nielsen","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Regional Hospital Kolding, Kolding, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R W","family":"Thomsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2013,1,3]]},"reference":[{"key":"2021031611425674200_bib1","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1038\/ajg.2009.507","article-title":"Causes of mortality in patients with peptic ulcer bleeding: a prospective cohort study of 10 428 cases","volume":"105","author":"Sung","year":"2010","journal-title":"Am J Gastroenterol"},{"key":"2021031611425674200_bib2","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1007\/s002689910045","article-title":"Trends in perforated peptic ulcer: incidence, etiology, treatment, and prognosis","volume":"24","author":"Svanes","year":"2000","journal-title":"World J 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