Struck E, De Vivie E R, Hehrlein F, Hügel W, Kalmar P, Sebening F, Wilde E
Cardiac Surgery Division, Augsburg Central Hospital, FRG.
Thorac Cardiovasc Surg. 1990 Apr;38(2):123-34. doi: 10.1055/s-2007-1014007.
A method for initiating quality assurance in cardiac surgery was developed multicentrically by a commission of the German Society for Thoracic and Cardiovascular Surgery (QUADRA Study). To appraise the quality of cardiosurgical action, variables were compiled from the preoperative, intraoperative, and postoperative treatment course. The data collection was carried out at the same time as treatment. On the basis of unicentric data profiles, multicentric hospital profiles, and problem profiles, a quality comparison could be carried out and the variability of cardiosurgical action which may occasion interventions could be identified. A reduction of perioperative blood consumption during the study period could be observed in four out of five hospitals as the first result. The data collection also revealed epidemiological features. On average, women were older than men at the time of the heart-valve and coronary operations. To ensure data validity and the organization of quality assurance, a documentation assistant and a specially trained physician are necessary at every cardiovascular surgery center. The multicentric external comparison is indispensable and must be carried out by means of a central data collection, for which intrumental and staff capacities are also to be provided. With modern methods of data processing, an additional and new approach to the improvement of quality in cardiac surgery can thus be made.
德国胸心血管外科学会的一个委员会多中心地开发了一种心脏手术质量保证启动方法（QUADRA研究）。为评估心脏手术操作的质量，从术前、术中和术后治疗过程中收集变量。数据收集与治疗同时进行。基于单中心数据概况、多中心医院概况和问题概况，可以进行质量比较，并识别可能需要干预的心脏手术操作的变异性。作为首个结果，在五家医院中的四家观察到研究期间围手术期血液消耗量有所减少。数据收集还揭示了流行病学特征。平均而言，在进行心脏瓣膜和冠状动脉手术时，女性比男性年龄更大。为确保数据有效性和质量保证的组织实施，每个心血管外科中心都需要一名文件助理和一名经过专门培训的医生。多中心外部比较不可或缺，必须通过中央数据收集来进行，为此还需提供仪器设备和人员能力。借助现代数据处理方法，从而可以为改善心脏手术质量开辟一条新的途径。
