Improving the Quality of Coronary Artery Bypass Grafting

Официальное название

Quality Improvement Intervention on Utilization of Arterial Grafts for Coronary Artery Bypass Grafting

Обзор

This is a healthcare quality improvement study focused on increasing the utilization of arterial grafts in isolated coronary artery bypass grafting (CABG). Evidence indicates that arterial grafts, compared with venous grafts, provide superior long-term patency, which are recommended to use by the clinical practice guidelines. In hospitals where the use of the internal mammary artery as a graft is relatively low(\<90%) among CABG patients, multiple interventions will be implemented to improve its adoption rate. In hospitals where internal mammary artery graft utilization is already high(≥90%), various interventions will be introduced to promote the use of multiple arterial grafts (defined as the use of two or more arterial conduits). The study targets healthcare professionals as the primary subjects of intervention, with no direct interventions applied to patients during the study period. Changes in the internal mammary artery graft utilization rate and the multiple arterial graft utilization rate before and after the intervention will serve as the primary endpoints for evaluating intervention effectiveness in the two types of hospitals, respectively.

Вмешательства

• Поведенческое Interventions for healthcare professionals in hospitals with low usage rates
  Hospitals with low usage rates aim to improve internal mammary artery graft utilization through interventions including education, theoretical training, technical training, conference exchanges, and regular feedback on quality monitoring results.
• Поведенческое Interventions for healthcare professionals in hospitals with high usage rates
  Hospitals with already high usage rates focus on increasing multi-arterial graft usage rates through similar intervention methods such as education, theoretical training, technical training, conference exchanges focus on multi-arterial graft use. The usage rates of multi-arterial graft for each hospital will be regular feed backed.

Первичные конечные точки

• Hospitals with low usage rates of internal mammary artery: internal mammary artery graft utilization rate [Срок оценки: Duration of hospital stay(from date of admission to date of discharge)]
• Hospitals with high usage rates of internal mammary artery: multiple arterial graft utilization rate [Срок оценки: Duration of hospital stay(from date of admission to date of discharge)]

Вторичные конечные точки (1)

• In-hospital all-cause mortality rate [Срок оценки: Duration of hospital stay(from date of admission to date of discharge)]

Критерии участия

Patients whose data used to monitor the quality

Критерии включения

Aged ≥ 18 years old； Indicated for CABG and undergoing CABG.

Критерии исключения

History of prior CABG; Concurrent other cardiac surgeries on the day of CABG; Malignant tumor or life expectancy < 1 year;

• 50% stenosis of left subclavian artery; Pregnant women; Individuals diagnosed with mental illness or cognitive impairment (International Classification of Diseases-10 codes F01-F99); Patients considered by the investigator to have other factors unsuitable for inclusion.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Не применимо

Модель

Одна группа

Маскирование

Открытое

Основная цель

Организация здравоохранения

Центры проведения

Список центров уточняется — проверьте первичный протокол.

Идентификаторы

NCT: NCT07377149 · 2025-2849 · 2025ZD0546704

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

Открыть это исследование на ClinicalTrials.gov ↗