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ICE 2008 1 Hellenic PCI Registry Organization - Structure - Directions - Initial Recordings Georgios I. Papaioannou, MD,

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Presentation on theme: "ICE 2008 1 Hellenic PCI Registry Organization - Structure - Directions - Initial Recordings Georgios I. Papaioannou, MD,"— Presentation transcript:

1 ICE 2008 1 Hellenic PCI Registry Organization - Structure - Directions - Initial Recordings http://registry.hellenicpci.gr/ Georgios I. Papaioannou, MD, MPH, FACC, FSCAI Athens Medical Center Cardiac Catheterization Laboratory 5/12/2008

2 ICE 2008 2 Aim of the Hellenic PCI Registry Common link with ESC (ESC PCI Registry) and EAPCI Recording of Centers/Operators/ Interventional Coronary Procedures with regional and national analyses Recording of basic indications, demographic, procedural and outcomes data of patients undergoing PCI National database for educational and professional requirements (in accordance to ESC/ACC) Quality and Outcomes Research

3 ICE 2008 3 Registries & Clinical Practice

4 ICE 2008 4 Greek Participation in the ESC PCI Registry Advantages –Existing structure –Simple process –Direct participation in ESC PCI –Instant comparison with ESC data –No expenses on time, structure and analyses Disadvantages –Certain format of database –No independent access and analyses of center data –No independent access and analyses of regional & national data

5 ICE 2008 5 Hellenic Heart Registry on PCI Initial attempt in 1998 – paper based Current decision of the WG of HSC for a f/u attempt Analyses at a national level & submission of data to the ESC Web-based database with secure data entry by individual users (user ID/password) Central analyses of data by the WG of HSC Each center may use the database for their own data analyses upon request

6 ICE 2008 6 Timetable of the PCI Registry 5/2006:WG decision 7/2006:Funding for the initial phase 9/2006:Collaboration with Philip Lees (Webmaster) 12/2006:Early design of database 3/2007:Testing version in a separate domain (Phase I) 7/2007:Phase II – Pilot cases entry (>300 patients, 9 centers) 2/2008:Phase III – Official start of Registry retrospectively from 1/1/2008 with a 3-5 year plan (>1000 patients entered so far in 2008)

7 ICE 2008 7 Database Organization Users (case entry) Local Administrators (case entry – contact person in each center) National Administrators (new center entry – new user entry – validation process)

8 ICE 2008 8 Users New User entry from National Administrators after User’s request Users: Registry enter with unique personal User ID/Password (automatic generation via software) Unique (not shared) e-mail address Users may change their own information subsequently

9 ICE 2008 9 Tables (8) Patient (Automatic entry ID-Demographics-Patient initials) Workup (History-Risk factors-Indication-Times-Admission Medications) PCI Angiogram (Angiographic findings based on the 15- segment model of ESC) PCI Procedure (Periprocedural medications-Additional diagnostic or theurapeutic devices-Complications) PCI Lesions (Lesion characteristics-PCI device-Result) Outcome (In-hospital outcome) Follow up (1 year/3 years/5 years) Submit (Automatic initial validation)

10 ICE 2008 10 ESC 15 Segment Model

11 ICE 2008 11 User Obligations List of cases entered that corresponds to the unique system ID (case is entered with initials only for patient confidentiality) Communication Information Watch for color coding F/U submission

12 ICE 2008 12 Case submitted… National Administrator confirms valid submission or rejects the entry and explains the reason via e-mail Case is permanent No edit of entered data can be performed The only open table is the F/U form

13 ICE 2008 13 Local Administrators Enter cases as regular Users Complete the form with Center Data for the previous year Contact Person for Center issues

14 ICE 2008 14 National Administrators New Users entry New Centers entry Validation process National Administrators do not have any authority to change or edit any data individual Users enter

15 ICE 2008 15 Recording Tips and Caution Patient history (Prior CAD, CHF, CRI) – under reporting Medications on admission (Aspirin, antiplatelets) – over reporting Timelines –STD: (0-3-6 hrs in STEMI) and (0-24-48 in NSTEMI) –DTB: Please record as much as possible accurate STEMI times due to small numbers / The majority of EU and USA centers have a DTB time >90 min In hospital events – Be accurate Explanation question boxes: Take a look!

16 ICE 2008 16 Centers/Operators/CABG on site - 2007

17 ICE 2008 17 PCI Centers - 2007

18 ICE 2008 18 COR/PCI Procedures - 2007

19 ICE 2008 19 COR/PCI Procedures - 2007 Coronary Angiograms Percutaneous Coronary Interventions

20 ICE 2008 20 COR & PCI Procedures / 10 6 population - 2007

21 ICE 2008 21 PCI Volume per Center - 2007

22 ICE 2008 22 PCI Centers & Primary PCI - 2007 *Technical ability to perform primary PCI

23 ICE 2008 23 Primary PCI numbers* - 2007 * Data from 27 Centers (6 Centers with data missing )

24 ICE 2008 24 Volume of Primary PCI in Centers with and without CABG on site - 2007 7,7% 69%31%

25 ICE 2008 25 Volume of Primary PCI per Center - 2007

26 ICE 2008 26 ESC PCI Registry (>28,000 pts) – Greece vs Europe (Δεδομένα έως 26/11/2008) Greece (%)Europe (%)OR Males85.0073.690.49* Smokers43.1426.060.46* Prior MI20.9235.902.12* Prior CHF1.0514.37>5* STEMI22.7222.78NS Primary PCI3.8315.93>5* Resc/Fac PCI2.641.500.4* CS0.541.60NA STEMI STD (hrs)2.002.92NE STEMI DTB (hrs)1.580.92NE *p<0.05 for OR

27 ICE 2008 27 ESC PCI Registry (>28,000 pts) – Greece vs Europe (Δεδομένα έως 26/11/2008) Greece (%)Europe (%)OR NSTEMI STD2.757.50NE NSTEMI DTB76.0030.15NE Femoral Vascular access99.3478.170.02* DES Implantation32.1037.95NS Stent length (11-20 mm)64.2156.020.71* Stent length>20 mm26.5835.211.50* Stent thrombosis1.050.59NS *p<0.05 for OR

28 ICE 2008 28 Benefits of HHR PCI Registry Physicians may record their own patients electronically Hospitals may establish their own database National status on PCI based on HSC Policy making for professional and educational reasons Direct participation and strengthening of Greek participation into the ESC/EAPCI

29 ICE 2008 29 Difficulties & Problems Motivation of physicians (multifactorial) Politics Clear understanding of the role and the benefits of the registry with broad participation in analyses Establish a structure especially in high-volume centers for secretarial help Loss of enthusiasm of existing users if a wide participation can not be achieved

30 ICE 2008 30 Hellenic Heart Registry on Percutaneous Coronary Interventions Link: http://registry.hellenicpci.gr/ Επικοινωνία: admin@hellenicpci.gr gpapaio@otenet.gr athanasios_kotsanis@hotmail.com Thank you for your participation!

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