Cardiology Division, Geneva University Hospitals, Geneva, Switzerland.
Institute of Primary Health Care (BIHAM), Bern University, Bern, Switzerland.
Eur Heart J Qual Care Clin Outcomes. 2023 Jun 21;9(4):331-341. doi: 10.1093/ehjqcco/qcac057.
To establish a set of quality indicators (QIs) for the cardiovascular (CV) assessment and management of patients undergoing non-cardiac surgery (NCS).
The Quality Indicator Committee of the European Society of Cardiology (ESC) and European Society of Anaesthesiology and Intensive Care (ESAIC) in collaboration with Task Force members of the 2022 ESC Guidelines on CV assessment and management of patients undergoing NCS followed the ESC methodology for QI development. This included (1) identification, by constructing a conceptual framework of care, of domains of the CV assessment, and management of patients with risk factors or established cardiovascular disease (CVD) who are considered for or undergoing NCS, (2) development of candidate QIs following a systematic literature review, (3) selection of the final set of QIs using a modified Delphi method, and (4) evaluation of the feasibility of the developed QIs. In total, eight main and nine secondary QIs were selected across six domains: (1) structural framework (written policy), (2) patient education and quality of life (CV risk discussion), (3) peri-operative risk assessment (indication for diagnostic tests), (4) peri-operative risk mitigation (use of hospital therapies), (5) follow-up (post-discharge assessment), and (6) outcomes (major CV events).
We present the 2022 ESC/ESAIC QIs for the CV assessment and management of patients with risk factors or established CVD who are considered for or are undergoing NCS y. These indicators are supported by evidence from the literature, underpinned by expert consensus, and align with the 2022 ESC Guidelines on CV assessment and management of patients undergoing NCS.
为非心脏手术（NCS）患者的心血管（CV）评估和管理建立一套质量指标（QIs）。
欧洲心脏病学会（ESC）和欧洲麻醉学会和重症监护学会（ESAIC）的质量指标委员会与 2022 年 ESC 关于 NCS 患者 CV 评估和管理指南的工作组成员合作，遵循 ESC 质量指标开发方法。这包括（1）通过构建护理概念框架，确定考虑或正在接受 NCS 的伴有危险因素或已确诊心血管疾病（CVD）的患者的 CV 评估和管理领域，（2）在系统文献回顾后制定候选 QIs，（3）使用改良 Delphi 方法选择最终 QIs 集，以及（4）评估所开发 QIs 的可行性。总共选择了六个领域的八项主要和九项次要 QIs：（1）结构框架（书面政策），（2）患者教育和生活质量（CV 风险讨论），（3）围手术期风险评估（诊断测试指征），（4）围手术期风险缓解（使用医院治疗），（5）随访（出院后评估），以及（6）结局（主要 CV 事件）。
我们提出了 2022 年 ESC/ESAIC 用于考虑或正在接受 NCS 的伴有危险因素或已确诊 CVD 的患者的 CV 评估和管理的 QIs。这些指标得到了文献证据的支持，得到了专家共识的支持，并与 2022 年 ESC 关于 NCS 患者 CV 评估和管理的指南一致。
