QUALITY ASSESSMENT FOR INVASIVE INTERVENTIONAL CARDIOLOGY IN AUSTRIA IN 1993

21769 diagnostic coronary angiographies and 4266 PTCA were performed in all 25 Austrian centres during the year 1993. This is 16% more angiographies and 13% more PTCA compared to 1992. 50% of all PTCA were done during the diagnostic study (= ad hoc), multi vessel PTCA in 14%, direct PTCA for acute infarction in 1.8%. Concerning ''new devices'', 182 stents (89 in the year 1992) were implanted in 1993, and 54 directional coronary atherectomies (DCA) performed (44 in the year 1992). Hospital mortality after PTCA was 0.5% (0.5% in 1992), emergency bypass surgery rate after PTCA was 0.7% (0.9% in 1992), and 1.2% of the patients were documented as myocardial infarction after PTCA (1.9% in 1992). Complicated coronary anatomy before PTCA accounted for about 50% of the indications, quality of the results after PTCA was tested by an exercise stress test before and after PTCA in six of 15 PTCA centers. In these centers 70.5% of their cases underwent exercise stress testing. Next year we are going to document and control quality of the indications and results in a more complete fashion than in 1993. Comparing Austria with other European countries it shows a leading position concerning 2721 diagnostic procedures per million inhabitants and year and 533 PTCA per million and year. The PTCA rate compared to the diagnostic rate (19.6%) indicates, that Austria relatively does more diagnostic than therapeutic interventions. Complication rate showed no correlation with frequencies of single Austrian centers, but centers with higher frequencies concerning numbers also have higher frequencies concerning the relative rate of PTCA per diagnostic angiography and concerning PTCA at the time of diagnostic study. The Austrian way of visiting all the cathlaboraties by monitors each year to control and - if necessary - to correct the documentation and to give a feedback comparison to mean values seems the best way so far and is accepted by all Austrian centers. This way of quality assessment includes the publication of the results, the correlation of the data to other countries and the changes from one year to another.