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Dive into the research topics where Martin Björck is active.

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Featured researches published by Martin Björck.


European Journal of Vascular and Endovascular Surgery | 1996

Incidence and Clinical Presentation of Bowel Ischaemia After Aortoiliac Surgery--2930 Operations from a Population-based Registry in Sweden*

Martin Björck; David Bergqvist; T Troeng

OBJECTIVES To study the incidence and clinical presentation of intestinal ischaemia after aortoiliac/femoral surgery, and to validate a vascular registry concerning a serious complication. DESIGN AND SETTING In the Swedish Vascular Registry (SWEDVASC) the outcome and complications of all vascular procedures are registered prospectively. MATERIALS AND METHODS All 2930 patients operated in 1987-93 were analysed for notified complications. A 5% random sample of all patients and a 20% random sample of fatal cases were analysed for un-notified complications. Of 415 requested patient records 413 were analysed. RESULTS The estimated incidence of bowel ischaemia was 2.8%. Among patients operated on for a ruptured aneurysm in shock it was 7.3%. Of the 63 patients with intestinal ischaemia only 15 presented with early passage of bloody stools. In 60 patients (95%) the lesion affected the left colon within the reach of a sigmoidoscope. Bowel ischemia was unnotified only in fatal cases, the estimated un-notified complication rate was 0.7%. CONCLUSIONS The incidence in this study on unselected patients did not differ from previous reports from specialised centres. Diagnosis is difficult and justifies a high index of suspicion and early use of sigmoidoscopy. The validity of the SWEDVASC registry was confirmed by a high report-rate for this complication.


World Journal of Surgery | 2009

Classification—Important Step to Improve Management of Patients with an Open Abdomen

Martin Björck; Andreas Bruhin; Michael L. Cheatham; Daniel Hinck; Mark Kaplan; Guiseppe Manca; Thomas Wild; Alastair Windsor

This short report is a distillation of the proceedings from a consensus group meeting in January 2009. It outlines a proposed classification system for patients with an open abdomen (OA). The classification allows (1) a description of the patient’s clinical course; (2) standardized clinical guidelines for improving OA management; and (3) improved reporting of OA status, which will facilitate comparisons between studies and heterogeneous patient populations. The following grading is suggested: grade 1A, clean OA without adherence between bowel and abdominal wall or fixity of the abdominal wall (lateralization); grade 1B, contaminated OA without adherence/fixity; grade 2A, clean OA developing adherence/fixity; grade 2B, contaminated OA developing adherence/fixity; grade 3, OA complicated by fistula formation; grade 4, frozen OA with adherent/fixed bowel, unable to close surgically, with or without fistula. We propose that this classification system will facilitate communication, clarify OA management, and potentially improve patient care.


Scandinavian Journal of Clinical & Laboratory Investigation | 2008

Diagnostic accuracy of plasma biomarkers for intestinal ischaemia

T. Block; Torbjörn K. Nilsson; Martin Björck; Stefan Acosta

Objective. Intestinal ischaemia is a life‐threatening condition with high mortality, and the lack of accurate and readily available diagnostic methods often results in delay in diagnosis and treatment. The aim of this study was to investigate the accuracy of different plasma biomarkers in diagnosing intestinal ischaemia. Material and methods. Prospective inclusion of patients older than 50 years with acute abdomen admitted to hospital in Karlskrona, Sweden, between 2001 and 2003. Venous blood was sampled prior to any surgery and within 24 h from onset of pain. D‐lactate, alpha glutathione S‐transferase, intestinal fatty acid binding protein, creatine kinase B, isoenzymes of lactate dehydrogenase (LD) and alkaline liver phosphatase (ALP) were analysed. D‐dimer was analysed using four different commercially available test kits. Results. In‐hospital mortalities among patients with (n = 10) and without (n = 61) intestinal ischaemia were 40 % and 3 %, respectively (p = 0.003). D‐dimer was associated with intestinal ischaemia (p = 0.001) independently of which assay was used. No patient presenting with a normal D‐dimer had intestinal ischaemia. D‐dimer >0.9 mg/L had a specificity, sensitivity and accuracy of 82 %, 60 % and 79 %, respectively. Total LD, isoenzymes of LD 1–4 and liver isoenzyme of ALP (ALP liver) were significantly higher in patients with intestinal ischaemia, and accuracies for LD 2 (cut‐off 2.3 µkat/L) and ALP liver (cut‐off 0.7 µkat/L) were 69 % and 66 %, respectively. Conclusions. D‐dimer may be used as an exclusion test for intestinal ischaemia, but lacks specificity. The other plasma biomarkers studied had insufficient accuracy for this group of patients. Further studies are needed.


British Journal of Surgery | 2008

Outcome after abdominal aortic aneurysm repair in Sweden 1994–2005

Anders Wanhainen; N Bylund; Martin Björck

The aim was to study the epidemiology of abdominal aortic aneurysm (AAA) repair in Sweden.


European Journal of Vascular and Endovascular Surgery | 2008

External validation of the Swedvasc registry : a first-time individual cross-matching with the unique personal identity number

T Troeng; J. Malmstedt; Martin Björck

OBJECTIVE To study external validity of the Swedvasc registry concerning numbers of procedures and mortality. MATERIALS AND METHODS Vascular registry data for carotid, infrainguinal bypass and aortic aneurysm (AAA) procedures were compared to the Swedish Hospital Discharge Register (SHDR) data, and the National Population Registry (for mortality) by matching every individual patient using the unique personal identity numbers (PINs). The time-period studied was 2000-2004 (5 years) for carotid and infrainguinal procedures. A separate analysis was performed for AAA-surgery in 2006. RESULTS The external validity for carotid, infrainguinal bypass and AAA repair was 93.4%, 93.0% and 93.1%, respectively. The 30-day mortality was 0.86% after carotid and 2.9% after infrainguinal bypass procedures. Mortality was 2.6% after planned and 25.9% after unplanned AAA repair. Although there was a general trend towards inferior outcomes after procedures not registered in the Swedvasc, those procedures were so few that in none of the analyses did the inclusion of non-registered procedures affect general outcomes significantly. Combining data from both registries, the incidence for carotid, infrainguinal bypass and AAA procedures was 7.8, 15.2 and 13.6 per 100,000 person-years, respectively. In the hospital-specific analysis for 2006 it was shown that the non-registered procedures for AAA were localized to one non-compliant county hospital, and small district hospitals not performing elective AAA-surgery but only rare emergency operations. CONCLUSION The external and internal validity of the Swedvasc registry allows to confidently assess volumes of, and mortality after, vascular surgery in Sweden.


European Journal of Vascular and Endovascular Surgery | 1997

Risk Factors for Intestinal Ischaemia after Aortoiliac Surgery: a Combined Cohort and Case-control Study of 2824 Operations

Martin Björck; T Troeng; David Bergqvist

OBJECTIVE To identify risk factors for intestinal ischaemia after aortoiliac surgery. MATERIALS AND METHODS Among 2824 patients operated on during 1987-93 and registered prospectively in the Swedish Vascular Registry, 62 cases of postoperative intestinal ischaemia were identified. They were compared with the remaining 2762 patients through the registry and with a random sample of 127 controls through patient records. Multivariate analysis was performed. RESULTS Patients in shock operated on for ruptured aneurysms were at greatest risk of developing postoperative intestinal ischaemia. Excluding patients in shock, operation for aneurysmal disease and for occlusive disease carried the same risk. Renal disease, emergency surgery, age, type of hospital, aortobifemoral graft, operating time, cross-clamping time and ligation of one or both internal iliac arteries were independent risk factors. CONCLUSIONS Patient-related haemodynamic risk factors together with surgical skill and decision making defines the risk for this serious complication.


Journal of Internal Medicine | 2006

Fatal nonocclusive mesenteric ischaemia: population-based incidence and risk factors

Stefan Acosta; Mats Ögren; Nils H Sternby; David Bergqvist; Martin Björck

Objectives.  To estimate the incidence and extension of visceral organ infarction, and to evaluate potential causes, in patients with autopsy‐verified nonocclusive mesenteric ischaemia (NOMI) and transmural intestinal infarction.


Journal of Vascular Surgery | 2009

Endovascular repair of mycotic aortic aneurysms

Karl Sörelius; Kevin Mani; Martin Björck; Rickard Nyman; Anders Wanhainen

PURPOSE We report our single-center experience of early and midterm outcome after endovascular repair of mycotic aortic aneurysms (MAA). METHODS Case records were retrospectively reviewed of 11 patients who underwent endovascular repair of 13 MAAs between 2000 and 2007. The aneurysms were localized in the aortic arch in 1 patient, descending thoracic aorta in 4, suprarenal abdominal aorta in 3, and infrarenal abdominal aorta in 5. RESULTS Mean follow-up was 27 months. A bleeding aortoesophageal fistula resulted in one in-hospital death <or=30 days. Three patients died later: one each of sepsis, stent migration that caused intestinal ischemia, and an unknown cause. Two patients had recurrent sepsis postoperatively but no vascular complications, two had elevated inflammatory markers during follow-up but were asymptomatic, and three patients had an uneventful follow-up. CONCLUSIONS Endovascular treatment for MAA was feasible, with acceptable perioperative mortality and midterm outcome in this single-center case series. Recurrent sepsis and late relapse with a second MAA occurred, indicating the need of long-term antibiotic therapy and follow-up, as well as the possible need for secondary open repair in selected cases. Further research is warranted to evaluate long-term outcome.


British Journal of Surgery | 2007

Nationwide study of the outcome of popliteal artery aneurysms treated surgically.

Hans Ravn; David Bergqvist; Martin Björck

The aim was to study the epidemiology and outcomes of popliteal artery aneurysm (PA) treated surgically.


British Journal of Surgery | 2004

D-dimer testing in patients with suspected acute thromboembolic occlusion of the superior mesenteric artery

Stefan Acosta; Torbjörn K. Nilsson; Martin Björck

There is no accurate non‐invasive method available for the diagnosis of acute thromboembolic occlusion of the superior mesenteric artery (SMA). The aim of this study was to assess the diagnostic properties of the fibrinolytic marker D‐dimer.

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David Bergqvist

Uppsala University Hospital

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T Troeng

Uppsala University Hospital

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