Higginson L A, Cairns J A, Keon W J, Smith E R
Department of Medicine, University of Ottawa, Ont.
CMAJ. 1992 Mar 15;146(6):921-5.
To determine the rates of and waiting lists for cardiac catheterization, percutaneous transluminal coronary angioplasty (PTCA) and open-heart surgery in adults in Canada between Apr. 1, 1988, and Mar. 31, 1989.
Mail survey.
The directors of all 48 adult cardiac catheterization laboratories and the chiefs of all 33 adult cardiovascular surgery programs in Canada.
A total of 61,116 cardiac catheterization procedures were performed, a rate of 236 per 100,000 population. The mean waiting times for elective procedures were weighted to reflect more accurately the differences between centres in the number of patients awaiting the procedures. The mean wait for elective cardiac catheterization was 8.5 weeks. There were 10,097 PTCA procedures done, a rate of 39 per 100,000 population. The mean wait for elective PTCA was 11.0 weeks, the longest wait occurring in Quebec (15.4 weeks). A total of 16,240 open-heart procedures were performed, a rate of 63 per 100,000 population. The mean wait for elective open-heart surgery was 22.6 weeks, the longest wait occurring in Quebec and British Columbia (more than 32 weeks). The rates for all three procedures were much lower in Canada than in the United States.
The results suggest that the cumulative wait for coronary angiography and PTCA or open-heart surgery may lead to major losses of productivity, delayed rehabilitation and reduced probability of return to previous levels of productivity. Regular collection of data such as ours should help to understand better the resources required for these specialized cardiac procedures.
确定1988年4月1日至1989年3月31日期间加拿大成年人进行心导管插入术、经皮腔内冠状动脉成形术(PTCA)和心脏直视手术的比例及等候名单情况。
邮寄调查。
加拿大所有48个成人心脏导管插入实验室的主任以及所有33个成人心血管外科项目的负责人。
共进行了61116例心导管插入术,每10万人中有236例。对择期手术的平均等待时间进行加权,以更准确地反映各中心等待手术患者数量的差异。择期心导管插入术的平均等待时间为8.5周。共进行了10097例PTCA手术,每10万人中有39例。择期PTCA的平均等待时间为11.0周,魁北克等待时间最长(15.4周)。共进行了16240例心脏直视手术,每10万人中有63例。择期心脏直视手术的平均等待时间为22.6周,魁北克和不列颠哥伦比亚等待时间最长(超过32周)。加拿大这三种手术比例均远低于美国。
结果表明,冠状动脉造影及PTCA或心脏直视手术的累计等待可能导致生产力大幅损失、康复延迟以及恢复到先前生产力水平的可能性降低。定期收集如我们所做的数据应有助于更好地了解这些心脏专科手术所需资源。