Author + information
- 1Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- 2Critical Care and Cardiovascular Center, Kaohsiung Veterans General Hospital, Nati, Kaohsiung, Taiwan
- 3Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- 4Koaohsiung Veterans General Hospital,Fooyin University, National Yang Ming University, Kaohsiung, Taiwan
Previous evidence showed any radiation might carry risk of skin or eye damage, malignant disease, or other hazards, which the U.S. radiation protection standards was also established based on this premise. However, most interventional cardiologists neglected protection of radiation exposure to the patients or operators. This aim of study is investigate the impact of multidisciplinary care model on reducing radiation exposure during percutaneous coronary intervention.
Since Jan, 2016, we organized a multidisciplinary team, including interventional cardiologists, dermatologist, intensivists, radiation technicians and nursing staffs. The patients, from 2 hospitals with cardiac catherization lab, were divided into 3 groups: stage 1 (n=64) from March to November 2016, stage 2 (n=42) from December 2016 to January 2017 and stage 3 (N=46) from February to May 2017. The key interventions include reduce frame rate of fluoroscopy with 15 frames/seconds instead of conventional 30 frames/seconds, reduce frame rate of video recording with 7.5 frames/seconds instead of conventional 15 frames/seconds, guideline for radiation protection and innovative head, eye and neck protection device. A P-value less than 0.05 was considered statistically significant.
There is no difference among 3 study groups in baseline characteristic. The eye radiation dose of patients improved from 4.5±3.9 mSV in stage 1, to 2.2±2.4 in stage 2 and 0.8±0.6 mSV in stage 3 (p<0.001). The neck radiation dose of patients reduced from 22.2±39.1 mSV in stage 1, to 8.1±8.6 in stage 2 and 4.1±3.7 mSV in stage 3 (p<0.001). The back radiation dose of patients reduced from 183.8±286.3 mSV in stage 1, to 39.2±49.8 in stage 2 and 33.5±45.1 mSV in stage 3 (p<0.001). The radiation dose of doctors reduced from 2.0±1.4 mSV in stage 1, to 1.1±1.3 in stage 2 and 1.2±0.7 mSV in stage 3 (p=0.001).
The multidisciplinary care model with lower radiation protocol and innovative protection device was demonstrated to reduce eye, neck and back radiation dose in percutaneous coronary intervention patients. Furthermore, lower radiation protocol can reduce radiation exposure of operators.
OTHER: Quality, Guidelines and Appropriateness Criteria