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Prospektive Datenerfassung und Qualitätskontrolle am Beispiel der Karotischirurgie

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Zusammenfassung

Ziel der vorliegenden Arbeit ist es, die Wichtigkeit einer internen Qualitätskontrolle am Beispiel der Karotischirurgie zu demonstrieren. Anhand eines prospektiven Patientenprotokolls wird der Frage nachgegangen, wie klinische, morphologische oder zerebrale Prädispositionen und die intraoperative Qualitätskontrolle mit Hilfe der Angiographie die Ergebnisse beeinflussen.

Zwischen dem 01.01.1996 und dem 31.01.2002 wurden 1426 Operationen an 1271 Patienten durchgeführt. 516 (36%) Eingriffe im Stadium I, 527 (37%) im Stadium II, 8 (0,5%) im Stadium III, 248 (17,5%) im Stadium IV und 127 (9%) Operationen waren in unserer speziellen Gruppe PIV/OPI.

Die perioperative, neurologische Defizitrate (ND) über alle Stadien betrug 2,2%. Passagere neurologische Ereignisse wurden in 1% der Fälle beobachtet. In Summe ergibt das 3,2% neurologische Vorkommnisse.

Als Ergebnis der prospektiven Erfassung und Evaluierung dieser Daten und der intraoperativen Kontrollangiographie konnte die jährliche perioperative permanente neurologische Defizitrate von 3% (1996) auf 0,8% (2002) gesenkt werden.

Abstract

Purpose.

The main goal of this study was to demonstrate the importance of an internal quality control in carotid artery surgery. On the basis of a prospective datasheet, clinical, morphologic, or cerebral predispositions and intraoperative quality control with angiography were evaluated.

Methods and results.

From 1 January 1996 to 31 January 2002, 1426 operations of the internal carotid artery were performed on 1271 patients. The data of all patients regarding preoperative evaluation, risk profiles, comorbidity and perioperative course were documented prospectively on a specially designed datasheet. The incidence of perioperative neurologic events was 3.2% and the mortality rate 0.2%. The technical result of all reconstruction was evaluated by intraoperative angiography.

Conclusion.

The continuous quality control of the technical results and relative surgical risk of each patient led to a significant reduction in perioperative neurologic events. The permanent neurologic deficit of all stages of cerebral vascular disease decreased from 3% in 1996 to 0.8% in 2002 in our unit.

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Mit großer Freude Herrn Prof. Dr. G.W. Hagmüller gewidmet.

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  1. 1. Chirurgie—Gefäßchirurgisches Zentrum Wilhelminenspital Wien

    H. Ptakovsky & A. Assadian

  2. 1. Chirurgie—Gefäßchirurgisches Zentrum, Wilhelminenspital Wien, Montleartstraße 34, 1160, Wien, Österreich

    H. Ptakovsky

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  1. H. Ptakovsky
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Ptakovsky, H., Assadian, A. Prospektive Datenerfassung und Qualitätskontrolle am Beispiel der Karotischirurgie. Gefässchirurgie 8, 9–16 (2003). https://doi.org/10.1007/s00772-002-0254-3

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