Better survival after transcatheter aortic valve replacement by process improvements
| Autor: | S Houterman, P A Tonino, G J van Steenbergen, D van Veghel, Lukas R.C. Dekker, Daniela N. Schulz, Mohamed A. Soliman-Hamad |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Multivariate statistics Quality management medicine.medical_treatment Psychological intervention Cardiology Value based health care 030204 cardiovascular system & hematology TAVR Logistic regression 03 medical and health sciences 0302 clinical medicine Valve replacement medicine 030212 general & internal medicine Outcome-based quality improvement Quality improvement business.industry Odds ratio Confidence interval Multidisciplinary meeting Emergency medicine Cohort Original Article Cardiology and Cardiovascular Medicine business Quality committee |
| Zdroj: | Netherlands Heart Journal |
| ISSN: | 1568-5888 |
| Popis: | ObjectiveThe aim of this study is to assess the effects on procedural, 30-day, and 1‑year all-cause mortality by a newly introduced quality improvement strategy in patients after transcatheter aortic valve replacement (TAVR).MethodsIn October 2015, a coherent set of quality improving interventions with respect to patient geriatric screening, general diagnostic examination and safety of the procedure was implemented at a single centre in the Netherlands. Patients undergoing TAVR in 2013–2018 were included for retrospective analysis. Mortality was assessed in the pre-quality improvement strategy cohort (January 2013 to October 2015; cohort A) and in the post-quality improvement strategy cohort (November 2015 to December 2018; cohort B). Logistic regression analysis was used to estimate the influence of patient and procedural characteristics on the results of the quality improvement strategy in terms of procedural, 30-day, and 1‑year all-cause mortality.ResultsIn total, 806 patients were analysed with 274 patients in cohort A and 532 patients in cohort B. After introduction of the quality improvement strategy, procedural (4.4% to 1.3%,p p p ConclusionStructural meetings on evaluation of outcomes highlight potential areas for improvement and subsequent outcome-based quality improvement initiatives can result in lower procedural, 30-day, and 1‑year all-cause mortality. |
| Databáze: | OpenAIRE |
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