Complications of diagnostic cardiac catheterisation: results from 34,041 patients in the United Kingdom confidential enquiry into cardiac catheter complications. The Joint Audit Committee of the British Cardiac Society and Royal College of Physicians of London.

OBJECTIVES: To evaluate the frequency and nature of complications in patients undergoing diagnostic cardiac catheterisation and to assess the feasibility of a voluntary cooperative audit system.
METHODS: 27 centres enrolled patients over a two year period. Each centre voluntarily reported numbers of patients catheterised every month. Complications were reported as they occurred. Feedback was provided in the form of newsletters and reports.
RESULTS: 39,795 procedures were registered, of which 33,776 were diagnostic catheterisations in adults or adolescents, 1265 were paediatric catheter studies in patients under the age of 12 years, and 4754 were coronary angioplasties or balloon dilatation of valves. 83.3% of diagnostic catheter studies in adults were left heart studies with coronary arteriography. The overall complication rate for diagnostic studies was 0.80%, mortality rate 0.12%, emergency surgical intervention rate 0.08%. Complication rates varied between centres, but there was no correlation with case load. Different patterns of complication were associated with different technical approaches.
CONCLUSIONS: Complication rates of diagnostic catheterisation are low but neither negligible nor irreducible. Voluntary audit of this kind has limitations, but it is useful and inexpensive.