[The practice of percutaneous coronary interventions in hospitals without on-site cardiac surgery: review of guidelines and analysis of Quebec data, 1999-2004]
Lambert L, Bogaty P, Brophy J, Boothroyd LJ
Record ID 32007000621
French
Original Title:
La pratique d’interventions coronariennes percutanées dans les hôpitaux sans service de chirurgie cardiaque sur place : revue des lignes directrices et analyse des données québécoises de 1999 à 2004
Authors' objectives:
Study question: To what extent is the Ministry justified in maintaining the position according to which the development of diagnostic and therapeutic catheterization should be reserved for centres with on-site surgical support or centres within an hour's reach of a centre with cardiac surgery?
To address this question, this study presents a review of the latest relevant guidelines, an examination of the available evidence, and an analysis of Quebec data. This analysis uses medico-administrative data to compare the outcomes of PCI performed in Quebec hospitals with and without on-site cardiac surgery.
Authors' recommendations:
In clinical medicine, as in other areas, demand tends to be a function of available supply. The creation of new PCI centres would, therefore, probably lead to the increased use of coronary angiography and PCI. Given the lack of evidence showing an improvement in survival associated with PCI being performed more quickly in most clinical settings, and given the risks associated with performing PCIs at facilities without on-site cardiac surgery, the real advantages of creating new PCI centres without surgical support are uncertain.
Consequently, based on a review of the latest guidelines, available evidence and a preliminary analysis of outcomes of PCI in Quwbec, this information brief underlines the need for caution in the creation, expansion and operation of PCI centres without on-site cardiac surgery. Given the considerable resources required to perform PCI and achieve its benefits, and the inherent risks associated with invasive interventions, this assessment emphasizes the importance of interhospital collaboration, the establishment of clear protocols, commitment to essential quality-of-care conditions, the need for a high-quality data registry, and the monitoring of performance, all measures essential to ensure the most favourable patient outcomes and optimal resource allocation.
Authors' methods:
Review
Details
Project Status:
Completed
Year Published:
2007
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Canada
MeSH Terms
- Cardiac Catheterization
- Cardiac Surgical Procedures
- Percutaneous Coronary Intervention
- Cardiovascular Diseases
Contact
Organisation Name:
Agence d'évaluation des technologies et des modes d'intervention en santé
Contact Address:
2021, avenue Union, Bureau 10.083,Montreal, Quebec H3A S29, Canada.Tel: +1 514 873 2563; Fax: +1 514 873 1369
Contact Name:
demande@inesss.qc.ca
Contact Email:
demande@inesss.qc.ca
Copyright:
Agence d'Evaluation des Technologies et des Modes d'Intervention en Sante (AETMIS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.