[Quality assurance in invasive and interventional cardiology in Austria for the 1995 calendar year]

A complete national database is the prerequisite for quality control, quality management and improvement. In Austria, we are reaching for this goal since more than 3 years. 23969 diagnostic coronary angiographies (CA) and 5898 PTCA were performed in all 25 adult-centers (out of which 18 perform PTCA) in Austria during the year 1995. This is an increase of 13.6% concerning CA and a 19.5% increase in PTCA compared to 1994. 50% of all PTCA were done during the diagnostic study (CA), direct PTCA for ongoing infarction in 2.8%. Concerning "new devices", 1572 stents (27% of the PTCA cases) were implanted in 1995. Hospital mortality after PTCA was 0.5% (unchanged to the years 1992 and 1993), emergency bypass surgery rate after PTCA was 0.8% (0.7% during the year 1993), and 1.3% of the patients suffered a myocardial infarction due to PTCA in the cath-lab (1.4% during 1994). International comparison shows Austria under the top nations with 2996 CA and 737 PTCA per million inhabitants, corresponding to a ratio of 41% PTCA and CABG per 100 CA. Out of 18 centers with PTCA-activity ischemia was proven to be present before PTCA in 2729 patients within 11 centers, primary-success-rate was documented in 14 centers concerning 3703 patients and a controlling exercise stress test within 3 months after PTCA was reported by 8 centers for 1555 patients. Local logbooks with continuous readings of complications, guidelines and monitor visits (audits) within all cath-labs in Austria turned out to be a better tool for quality control than computer-databases. But additional electronic databases will be necessary in the future. Austria is the only nation worldwide to support a complete national database with controlled numbers and parameters since more than three years, including complete yearly monitor visits and feedback reports. We experienced no single negative reaction to our activities, but find them necessary for further quality management targets.