Key result
Fellow involvement in invasive procedures is linked to ~38% longer fluoroscopy time vs staff alone.
Why the study?
The impact of invasive cardiology training of fellows on patient radiological exposure parameters was not well quantified.
Observational (n=3,401)
No
Answers are grounded in this paper and cite their sources.
The aim of this work was to evaluate and quantify the impact of an invasive training of cardiology fellows on some exposure parameters. From 1 January 2000 to 31 December 2002, three staff members performed 2.582 diagnostic procedures (Group 1) that were compared with 819 performed by, or with the participation of five cardiology fellows (Group 2). Exposure parameters were as follows (Group 1/Group 2): fluoroscopy time 3.8 ± 4.5/5.5 ± 5.9 min (+38%), mean number of frames 589 ± 282/642 ± 260 (+9%), Kerma-area product (KAP) during fluoroscopy 10.6 ± 14/15.5 ± 16 Gycm2 (+45%), KAP during cine-angiography 20.8 ± 14/22.5 ± 12 (+8%), total KAP 31.5 ± 28/38.1 ± 28 (+21%). Differences were all significant (P ≤ 0.001 for all comparisons). For individual fellows, a trend towards reduction of exposure parameters was seen over time, but only KAPcine was significant (25.7 ± 14/22.2 ± 11 Gycm2, P ≤ 0.001). In conclusion, all parameters measured in this study increased significantly in diagnostic procedures performed with fellows when compared with staff members alone, fluoroscopy time and the related KAP in particular. Careful supervision limited these increases so that exposures remained within acceptable limits.
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Bernardi et al. (2007) conducted an observational in Diagnostic invasive cardiology procedures (n=3,401). Participation of cardiology fellows vs. Staff members alone was evaluated on Fluoroscopy time (+38%, p=≤0.001). The participation of cardiology fellows in diagnostic invasive procedures significantly increased fluoroscopy time by 38% and total Kerma-area product by 21% compared to procedures performed by staff alone.
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