Spektrum der Augenheilkunde

, Volume 25, Issue 6, pp 377–380 | Cite as

Qualitäts-Statistik von Operationen an der Augenabteilung des Krankenhauses Hietzing in Wien

  • B. Weingessel
  • C. Vécsei
  • P. Irsigler
  • P.V. Vécsei-Marlovits
Originalarbeit

Zusammenfassung

HINTERGRUND: Die Komplikationsraten als Kriterium für die Qualität bei Katarakt-Operationen variieren in der Literatur zwischen 2,3 % bis 27,4 %. Die Re-Operationsraten bei vitreoretinalen Operationen liegen zwischen 1,1 % und 14 %. Es gibt verschiedene prä- und intraoperative Faktoren, die einen Einfluss auf die Komplikationsrate haben. Aber auch die Erfahrenheit der ChirurgIn und die Strukturiertheit der Ausbildung haben Auswirkungen, ebenso wie das intraoperative Management. MATERIAL UND METHODE: Retrospektive Untersuchung aller Operationen, die zwischen Jänner 2007 und März 2011 an der Augenabteilung durchgeführt wurden, mit Schwerpunkt auf Katarakt- und vitreoretinale Operationen. Basierend auf den Komplikationsraten von 2007 und 2008 kamen folgende Maßnahmen zur Anwendung: präoperative Identifikation von prä- und intraoperativen Risikofaktoren, die Auswahl einer/s geeigneten Operateur/in, konsequentes intraoperatives Komplikationsmanagement und ein strukturierter Ausbildungsplan für AssistenzärztInnen. RESULTATE: Reduktion der Re-Operationsrate bei Katarakt-Operationen um 66,8 % seit 2007 bzw. um 64,8 % seit 2008 und der Re-Operationsrate von vitreoretinalen Operationen um 86,6 % im Vergleich zu 2007 bzw. 59,3 % zu 2008. SCHLUSSFOLGERUNG: Die Berücksichtigung von prä- und intraoperativen Risikofaktoren, die Auswahl einer/s geeigneten Operateur/in, konsequentes intraoperatives Komplikationsmanagement und ein strukturierter Ausbildungsplan für AssistenzärztInnen führt zu einer wesentlichen Reduktion von OP-Komplikationen und Re-Operationen.

Keywords

Katarakt-Operation Vitreoretinale Operation Intraoperative Komplikationen Re-Operationen Ausbildung von ChirurgInnen 

Surgery Quality-Statistics at the Department of Ophthalmology, Hospital Hietzing Vienna

Summary

BACKGROUND: Intraoperative complication rate as quality-criteria in cataract-surgery varies from 2.3 % to 27.4 % in literature. Re-surgery rate for vitreoretinal surgeries ranges from 1.1 % to 14 %. Some preoperative conditions and intraoperative factors have a serious impact on complication rate. Other affecting factors are the surgeon's expertness, the structure of the surgical curriculum and the intraoperative management. MATERIAL AND METHODS: A retrospective chart review of 17.665 surgeries, the number of cataract surgeries and vitreoretinal surgeries were recorded, data of re-surgeries due to complications were collected. Based on complication rates of the year 2007 and 2008 the following actions were taken: Identification of pre- and intraoperative risk factors, allocating complicated surgeries to experienced surgeons, consistent intraoperative management and a structured surgical curriculum. RESULTS: Massive reduction of re-surgeries in both cataract and vitreoretinal surgery was achieved, 66.8 % for cataract surgery and 86.6 % for vitreoretinal surgery. CONCLUSIONS: Identifying pre- and intraoperative risk factors, allocating complicated surgeries to experienced surgeons, consistent intraoperative management and a structured surgical curriculum reduce intraoperative complications and re-surgery rate dramatically.

Keywords

Cataract-Surgery Vitreoretinal Surgery Intraoperative Complications Re-surgery rate Training of Surgeons 

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • B. Weingessel
    • 1
    • 2
  • C. Vécsei
    • 2
  • P. Irsigler
    • 1
    • 2
  • P.V. Vécsei-Marlovits
    • 1
    • 2
  1. 1.AugenabteilungKH Hietzing mit Neurologischem Zentrum RosenhügelWien
  2. 2.Karl Landsteiner Institut für Prozessoptimierung und Qualitätsmanagement in der KataraktchirurgieAustria

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