Quality control for invasive and interventional cardiology in Austria in 1994

A complete National Database is the prerequisite for quality control, quality management and improvement. In Austria, we have been reaching for this goal since more than three years. 21 094 diagnostic coronary angiographies (CA) and 4934 PTCAs were performed in all 27 centers (out of which 17 perform PTCA) in Austria during the year 1994. This is a reduction of 3.2% concerning CA and an 8.6% increase in PTCA compared to 1993. 48% of all PTCAs were done during the diagnostic study (CA), multivessel PTCA in 11%, direct PTCA for ongoing infarction in 2.3%. Concerning ''new devices'', 437 stents (182 during the year 1993) were implanted in 1994; also all 73 cases with rotablator, 105 with intracoronary ultrasound, and 26 directional coronary atherectomies (DCA) are documented. Hospital mortality after PTCA was 0.5% (unchanged from the years 1992 and 1993), emergency bypass surgery rate after PTCA was 1.2% (0.7% during the year 1993), and 1.4% of the patients suffered a myocardial infarction in the cathlab (1.2% during 1993). International comparison shows Austria among the top nations with 2637 CA and 617 PTCA per million inhabitants, corresponding to a ratio of 23% PTCA per 100 CA. Risk adjustment (exercise stress test pre PTCA documented in six cath-labs in 1993, compared to 11 in 1994; Type of stenosis (A, B, C) in five labs in 1993 and in 12 labs in 1994) and outcome control (exercise stress test 3 months after PTCA documented in five cath-labs in 1993, compared to 10 in 1994) are subject to constant improvement of our yearly monitor visits and feedback reaction. Austria is the only nation worldwide to support a complete national database with controlled numbers and parameters since more than 3 years, including yearly monitor visits (Internet address for the 1995 data: http://info.uibk.ac.at/gin/org/i-iik.stu/i-iik.htm) and feedback reports. We experienced no single negative reaction to our activities, but find them necessary for further quality management targets.