[Referral pattern of the heart catheterization laboratory at the Bern Island University Hospital]

Coronary angiography is a common diagnostic procedure to identify patients with coronary artery disease who need to undergo revascularization. It is expensive, carries a certain risk and must therefore be thoroughly scrutinized. An expert panel evaluated the indication criteria (Swiss Guidelines) to serve as a decision basis for the work-up of patients. The presented data acquisition considers the pathway of assignment as well as demographic data in addition to these criteria. A total of 2369 patients were referred to the cardiac catheterization laboratory of the University Hospital of Berne in 1996. Of these, 504 (21%) were randomly analyzed retrospectively. The selection consisted of the first 84 patients every second month. For 90% of these patients, the Swiss Guidelines attested an appropriate indication. The majority of the remaining 10% of the patients showed an appropriate indication as well which, however, had not been included into the Swiss Guidelines. Compared with other studies it is of note that one third of the patients underwent no prior stress test. In contrast, in a similar study in Frankfurt three quarters of the patients had a stress test to assess the chest pain before angiography. An increased percentage of patients with a previous coronary angioplasty was found in Berne. It may reflect the more recent period of data collection. The data represent a valid impression of the patient mix of the cardiac catheterization laboratory at the University Hospital of Berne. The indications for coronary angiography were found to be appropriate in virtually all cases. Demographic variables and procedure results are in keeping with comparable studies.