[Quality assurance in invasive cardiology: Switzerland].
In Switzerland, since 1985 mortality and morbidity data concerning either diagnostic and therapeutical coronary catheterization have been annually collected and analyzed. All interventional centres of the country (1994: 5 universities, 9 private and 3 public non academic hospitals) delivered their respective data. While there was a marked increase in diagnostic catheterizations (1989: 11'197, 1994: 20'603) and PTCAs (1989: 1'976, 1994: 5'590), the incidence of procedure related myocardial infarctions, emergency coronary artery bypass graftings (CABG) and in-hospital deaths evolved as shown in table 1 (results separated for university and non-university centres). Procedure related myocardial infarction and emergency CABG rates in patients undergoing PTCA have dropped from 2.1% to 0.9% and 3.1% to 1%, respectively, within 5 years. In the same period of time, the incidence of myocardial infarction after PTCA slightly increased from 0.7% to 0.9%. The higher rates of infarction and death in university hospitals do not necessarily mean poor quality of treatment but may reflect a more complex patient population in these centres. Furthermore, as declaring complications tends to be influenced by the concern of a negative impact on referrals, our data probably underestimate the true complications rates. For future surveys we consider anonymous data presentation and per-sonal audits at the individual centres.
Goerre
S
S
Kardiologie, Universitätsklinik Inselspital, Bern.
Meier
B
B
D015906:Angioplasty, Balloon, Coronary / Q000639:trends*; D006328:Cardiac Catheterization / Q000639:trends*; D001026:Coronary Artery Bypass / Q000639:trends*; D005544:Forecasting; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D009313:National Health Programs / Q000639:trends*; D011785:Quality Assurance, Health Care / Q000639:trends*; D016019:Survival Analysis; D013557:Switzerland