Abstract:In recent years, the scale of the endovascular abdominal aortic aneurysm repair (EVAR) in China has rapidly expanded, while the operation units have expanded from the regional center hospitals in the early years to the medium-sized hospitals in many provinces and cities. The quality problems related to the poor homogeneity of medical level and the unreasonable consumption of medical resources have gradually emerged. The major issue of how to evaluate and improve the quality of medical care and improve the utilization efficiency of national healthcare expenditures has drawn great attention from the national health authorities. All members of Working Group on Vascular Surgery, National Center for Cardiovascular Quality Improvement have discussed and formulated process index, outcome index and structural index for EVAR. Process index includes preoperative CTA examination, blood pressure monitoring and control during the operation, suitable oversizing of stent graft, and postoperative CTA review. Outcome index includes risk-adjusted 30-day mortality, risk-adjusted 30-day all-cause re-admission rate, incidence of conversions to open surgery, incidence of re-intervention for the access vessel, re-intervention rate for the abdominal aorta and iliac arteries, operation time, ICU stay time, incidence of prolonged mechanical ventilation, postoperative renal insufficiency, and postoperative hospitalization days. Structural index includes participation rate of registration researches. With the promoting and assessing of above-mentioned key indexes, the homogeneity of EVAR surgical quality in different hospitals from different regions and levels will hopefully be improved.uation; Expert Consensus.
