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BCIS Audit Returns of Interventional Procedures 2001

BCIS Audit Returns of Interventional Procedures 2001. Edinburgh 2002. Mark de Belder BCIS National Audit Officer on behalf of Council of the British Cardiovascular Intervention Society. UK Intervention Centres. Ayrshire & Arran stopped; Sandwell stopped;

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BCIS Audit Returns of Interventional Procedures 2001

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  1. BCIS Audit Returns of Interventional Procedures 2001 Edinburgh 2002 Mark de Belder BCIS National Audit Officer on behalf of Council of the British Cardiovascular Intervention Society

  2. UK Intervention Centres Ayrshire & Arran stopped; Sandwell stopped; Taunton started; Heart Hospital merged with Middlesex/UCH

  3. UK Interventional & Diagnostic Centres 2001 Making assumptions about no. of caths done in centres not reporting, estimated caths in UK approx 155,500 = 4.0caths/PCI (4.3 in 2000). 2.8caths/PCI in intervention centres (range 1.2-60, 3.5 in 2000), 2.7 in NHS centres (3.5 in 2000) and 3.7 in Private centres (unchanged)

  4. Centres providing NO DATA The Priory Hospital, Birmingham

  5. Centres providing NO or MINIMAL data on Centre Description Form • Royal Devon & Exeter • Wellington Hospital • Ross Hall Hospital • St Anthony’s Hospital • The Priory Hospital, Birmingham • Harley Street Clinic

  6. No data The Priory, Birmingham Minimal Data Royal Devon & Exeter Wellington Ross Hall Hospital St Anthony’s BUPA Bristol Centres providing NO or MINIMAL DATAon Minimum Data Form

  7. Belfast City City, Birmingham Bristol Royal Infirmary Yorkshire Heart Centre UH Wales, Cardiff London Chest Freeman, Newcastle Northern, Sheffield St Bartholomew’s Royal Devon & Exeter Derriford, Plymouth Eastbourne Wellington Ross Hall London Independent St Anthony’s The Priory, Birmingham Harley St Clinic BUPA Bristol BUPA Lea Cambridge NB Harefield, MRI, Oxford, Brompton and St Mary’s much improved! Centres with MINIMAL or NO DATAon Outcome Form

  8. Cath Lab Data Only Belfast City City Hospital, Birmingham Blackpool Bristol Royal Infirmary Yorkshire Heart Centre Papworth Glasgow Western General Hairmyres Morriston, Swansea Eastbourne BMI Alexander, Manchester BUPA Leeds London Bridge Hospital BUPA Leicester St Anthony’sl HCI Glasgow Harley Street Clinic Unspecified Data Univ. Hosp. Of Wales Edinburgh Royal Infirmary Glasgow Royal Infirmary The London Chest Manchester Royal Infirmary Wythenshawe Heart/Middlesex/UCH Freeman, Newcastle Northern Gen. Sheffield St Bartholomew’s Royal Devon & Exeter Derriford, Plymouth Taunton Centres with no HOSPITAL Outcome Data Unspecified Data • Wellington • Cromwell • Ross Hall • London Independent • The Priory, Birmingham • BUPA Bristol • Yorkshire Clinic, Bradford • BUPA Lea, Cambridge

  9. Number of procedures in NHS CentresTotal number of procedures per annum

  10. Total UK PCI Procedures

  11. PCI Rates per million population (UK) ?

  12. Census: UK population 58.8m 663pm PCI Rates per million population (UK)

  13. PCI vs Isolated CABG Rates (UK)Data from BCIS and SCTS Registry

  14. NSF Targets

  15. NSF Targets - Some thoughts 1. To increase to 750 pm PCIs, would need a 13% growth in PCI activity 2. To increase to 750 pm CABGs*, would need a 57% growth in CABG activity 3. To increase to 1500 pm revascularisations with 500 by CABG and 1000 by PCI, would need a 5% growth in CABG and a 51% growth in PCI 1 will almost certainly occur in 2002 2 will almost certainly not occur for some years 3 is highly feasible with sufficient resources diverted to PCI * including isolated CABG and combined valve+CABG

  16. PCI: UK 1996-2000 & 2001 vs Other European Countries 1996/2000 +44% +40% +40% +55% +180% +70% +64% +53% +19% If growth in PCI in UK continues at same rate, it will take >10 years to reach levels of PCI currently performed in France or Switzerland

  17. Total revascularisation rates per million in European countries in 2000

  18. PCI and CABG rates per million in European countries in 2000 2.3 3.3 5.4 2.4 4.1 3.0 1.7 1.4 2.8 2.0 0.9 4.2 1.3 1.8 1.4 2.0 0.7

  19. Angiography and PCI rates per million in European countries in 2000 3.3 3.4 2.5 2.7 2.6 2.5 2.7 2.6 3.2 4.3 3.0 4.0 3.3 3.2 2.8 6.6 2.8

  20. PCI Centres per million in European countries in 2000

  21. PCIs per PCI Centre in European countries in 2000

  22. PCI numbers in UK CountriesTotal PCIs +20% -18% +16% +14% +12% -4% *Does not account for patients referred from N. Wales to English centres

  23. PCI in UK countries 2000 and 2001PCIs/million population +17% +16% +12% -4% *Does not account for patients referred from N. Wales to English Centres

  24. Response to the NSF?Changes in PCI Numbers by NHS centre in England 2001 vs 2000For centres performing >100 PCI’s/year

  25. Changes in PCI Numbers by “NHS” centre in Scotland, N.Ireland & Wales 2001 vs 2000For centres performing >100 PCI’s/year Scotland N.Ireland Wales

  26. No. of Consultant Interventionists in NHS Centres, 2001 data from 48 centres Average 6.1 / Centre (5.5 in 2000) Total 292 = 287 Cardiologists and 5 Interventional Radiologists

  27. NHS Centres with and without Visiting Interventionists No Visitor Centres: 4.3 Interventionists/Centre, doing an average of 160 PCIs/year Visitor Centres: 4.0 Local and 3.7 Visitors/Centre, doing an average of 130 PCIs/year

  28. No of PCIs per Consultant in NHS Centres, 2001data from 48 centres Average 126 / Consultant (125 in 2000)

  29. All PCI Procedures Mortality 2001 data from 45 centres

  30. All PCI procedures2001 data from 42 centres

  31. Stent procedures 1992 - 20012001 data from 58 centres 86%

  32. Stenting in different centres 1998-20012001 data from 58 centres

  33. Impact of Stenting 1992-20012001 data from 42 centres

  34. Stenting and the need for emergency CABG (2001 data from 42 centres)

  35. Stenting and procedures for restenosis (2001 data from 42 centres)

  36. PCI for Restenosis 1998 - 2001(2001 data from 42 centres)

  37. Stent Procedures 1992 - 20012001 data from 25 centres

  38. Stent use 1997 - 2001(2001 data from 25 centres)

  39. ReoPro in different centres 1999 - 20012001 data from 56 centres ReoPro used in 38% (cf 22% in 2000) 1001 cases using eptifibatide(927) or tirofiban (74) reported Total reported GP IIb/IIIa use =41%

  40. ReoPro use 1997 - 20012001 data from 56 centres

  41. Other procedures 2001 - 1 +, =, - : increase, no change or decrease compared to 2000 * mainly X-sizer, some Rescue device

  42. Other procedures 2001 - 2 +, =, - : increase, no change, or decrease compared to 2000 * Mainly Angioseal

  43. Other Procedures 2001 - 3 +, =, - : increase, no change, or decrease compared to 2000

  44. Other Procedures 2001 - 4 +, =, - : increase, no change or decrease compared to 2000 * Some centres give combined data for ASD/PFO closure

  45. Other Procedures 2001 - 5 +, =, - : increase, no change, or decrease compared to 2000

  46. Other procedures 2001 - 6 +, =, - : increase, no change, or decrease compared to 2000

  47. Aberdeen Belfast Royal Victoria Birmingham Heartlands Birmingham QE Guy’s & St Thomas’s Hammersmith Harefield* Hull Royal Infirmary King’s College Hospital Walsgrave, Coventry Edinburgh Western Liverpool CTC John Radcliffe, Oxford Brompton Glenfield Royal Free Stoke Southampton St George’s* St Mary’s* James Cook UH, Middlesbrough Nottingham City Hospital KE VIIth, Midhurst Royal Sussex County, Brighton RCH Truro Park, Nottingham Centres providing complete or near complete data on Hospital Outcome 2001 (26, cf 18 2000) * Data incomplete

  48. Hospital Outcome 2001All patientsData from 26 centres

  49. Examples of different case-mix

  50. Hospital Outcome 2001Elective patients

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