Angioplastica coronarica (con PTCA): volume annuale di interventi chirurgici


Indice

Descrizione indicatore

L’indicatore ci consente di calcolare il numero di interventi chirurgici di angioplastica coronarica (con PTCA) eseguiti in un anno in una struttura ospedaliera (indicatore di "volume").

Come si legge

L’indicatore si riferisce al grado di “competenza" e di “sicurezza" delle cure prestate. 
Più alto è il numero d’interventi chirurgici di angioplastica coronarica (PTCA) eseguiti in una struttura, maggiore è il grado di esperienza della struttura stessa e la sicurezza del trattamento offerto.

Descrizione generale

La sigla PTCA (che in inglese sta per "percutaneous transluminal coronary angioplasty") identifica l’intervento noto in italiano come "angioplastica coronarica": è la tecnica che permette di dilatare il tratto di arteria coronaria occluso o significativamente ristretto in modo da consentire nuovamente il normale afflusso di sangue al cuore. 
L’angioplastica è un intervento piuttosto frequente che può essere usato per esempio per far regredire i sintomi di una coronaropatia, ad esempio l’angina (dolore al torace) e i problemi respiratori o per limitare i danni al muscolo cardiaco provocati da un infarto miocardico acuto (IMA). 
È noto che se la PTCA viene effettuata nelle fasi iniziali di un IMA, la mortalità a breve termine del paziente è minore.

Valutazione istituzionale

Il Ministero della Salute ha identificato la seguente soglia minima di volume di attività: 250 procedure/anno di cui almeno il 30% angioplastiche primarie in infarto del miocardio con sopra-slivellamento del tratto ST (IMA-STEMI).

Codici ICD-9-CM selezionati

Sono inclusi tutti i ricoveri, in regime ordinario, con i seguenti codici ICD-9-CM in qualsiasi campo di procedura: 00.66, 36.01, 36.02, 36.05, 36.06, 36.07.
Il volume di ricoveri per interventi chirurgici è calcolato su base annuale, riferito all’anno di dimissione del ricovero.
 

Consulta le strutture sanitarie che effettuano in un anno il maggior numero di interventi chirurgici di angioplastica coronarica (con PTCA)

Fonte del dato 

Programma Nazionale Esiti 2018, indicatore 113. 
Confronto tra strutture calcolato su dati 2017. 

Nota bene: Per tener conto di errori nell’attribuzione di condizioni/interventi a singoli ospedali, sono state escluse dalle analisi tutte le strutture con volumi di attività molto bassi in relazione alla condizione considerata (volume di attività minimo 10 casi/anno). 
Come riportato nel documento elaborato dal PNE, la definizione dell’esposizione sulla base dei volumi della struttura piuttosto che dell’unità operativa potrebbe essere soggetta a misclassificazione. 
Le informazioni contenute nelle SDO non consentono di identificare validamente le PTCA eseguite in service in strutture diverse da quella di degenza. Questo comporta una possibile misclassificazione del volume di attività, con sovrastima del numero degli ospedali a basso volume a cui viene attribuita l’esecuzione della procedura e una sottostima del volume di PTCA di altri ospedali.

Fonte della Valutazione Istituzionale

Il semaforo è calcolato sulla base del seguente documento ufficiale:

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