Document Detail


Surgical standby for percutaneous transluminal coronary angioplasty: a survey of patterns of practice.
MedLine Citation:
PMID:  2369227     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To determine patterns of surgical standby for percutaneous transluminal coronary angioplasty (PTCA), a questionnaire was mailed to 196 US institutions in which PTCA and coronary artery bypass grafting (CABG) are performed regularly. Eighty-nine responses (46%) were received and comprise this report. Of responding institutions, the mean number of hospital beds was 615. In 1987, these institutions performed a mean of 337 PTCAs and 558 open-heart surgical procedures. The rate of emergency CABG for PTCA complications (occlusion, dissection, or coronary perforation) was 4.4% +/- 0.3%, whereas the rate of urgent CABG (within 24 hours) for PTCA failure was 3.7 +/- 0.6%. The incidence of emergency CABG for PTCA complications was higher (5.1% +/- 0.6%) among low-volume PTCA centers (less than 250 cases per year) than at high-volume centers (more than 250 cases per year) (3.7% +/- 0.3%; p less than 0.05). The most common pattern of surgical backup was to maintain an open operating room on standby (57/89, 64%), and the second most common pattern was to make the next open operating room available, allowing operating room access within 1 to 3 hours (21/89, 24%). Nearly a third of institutions (26/89, 29%) maintained a flexible backup arrangement according to PTCA risk. Routine pre-PTCA patient evaluation by surgeon and/or anesthesiologist occurred in 38% (34/89). Fees for standby services were charged by 51% of surgical teams (45/89), 39% of anesthesia teams (35/89), and 38% of operating room facilities (34/89).(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
D E Cameron; D C Stinson; P S Greene; T J Gardner
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  50     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1990 Jul 
Date Detail:
Created Date:  1990-08-13     Completed Date:  1990-08-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  35-9     Citation Subset:  AIM; IM    
Affiliation:
Johns Hopkins Medical Institutions, Baltimore, Maryland.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary* / economics,  statistics & numerical data
Attitude of Health Personnel
Consumer Satisfaction
Coronary Artery Bypass* / economics,  statistics & numerical data
Coronary Disease / surgery,  therapy*
Costs and Cost Analysis
Emergencies
Hospital Bed Capacity
Humans
Physician's Practice Patterns*
Risk Factors
Comments/Corrections
Comment In:
Ann Thorac Surg. 1990 Jul;50(1):3-4   [PMID:  2369226 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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