Hostname: page-component-848d4c4894-x5gtn Total loading time: 0 Render date: 2024-05-29T03:57:54.354Z Has data issue: false hasContentIssue false

Validating a risk assessment tool in United Kingdom and Irish paediatric cardiac catheterisation practice

Published online by Cambridge University Press:  14 October 2021

Barry O’Callaghan
Affiliation:
The Heart Institute, Children’s Hospital of Colorado, University of Colorado, Denver, CO, USA Bristol Royal Hospital for Children, University Hospitals Bristol NHS Trust, Bristol, UK
Emma Shepherd
Affiliation:
Bristol Royal Hospital for Children, University Hospitals Bristol NHS Trust, Bristol, UK
Demetris Taliotis
Affiliation:
Bristol Royal Hospital for Children, University Hospitals Bristol NHS Trust, Bristol, UK
James Bentham
Affiliation:
Leeds Congenital Heart Unit, The Leeds Teaching Hospitals NHS Trust, Leeds, UK
Damien Kenny
Affiliation:
Department of Pediatric and Congenital Cardiology, Children’s Health Ireland Crumlin, Dublin, Ireland
Benjamin Smith
Affiliation:
Department of Pediatric and Congenital Cardiology, Royal Hospital for Children, Glasgow, NHS Greater Glasgow & Clyde, Glasgow, UK
Salvador Rodriguez Franco
Affiliation:
The Heart Institute, Children’s Hospital of Colorado, University of Colorado, Denver, CO, USA
Gareth J. Morgan*
Affiliation:
The Heart Institute, Children’s Hospital of Colorado, University of Colorado, Denver, CO, USA Department of Pediatric and Congenital Cardiology, The Evelina Children’s Hospital, Guy’s and St Thomas’s NHS Trust, London, UK
*
Author for correspondence: Dr G. J. Morgan, Director of Congenital Interventional Cardiology, Associate Professor of Pediatrics, The Heart Institute, Children’s Hospital of Colorado, University of Colorado, Denver, CO, USA. Tel: +17207773379; Fax: +17207777177. Email: drgarethjmorgan@gmail.com

Abstract

Background:

No established risk prediction tool exists in United Kingdom and Irish Paediatric Cardiology practice for patients undergoing cardiac catheterisation. The Catheterisation RISk score for Paediatrics is used primarily in North American practice to assess risk prior to cardiac catheterisation. Validating the utility and transferability of such a tool in practice provides the opportunity to employ an already established risk assessment tool in everyday practice.

Aims:

To ascertain whether the Catheterisation RISk score for Paediatrics assessment tool can accurately predict complications within United Kingdom and Irish congenital catheterisation practice.

Methods:

Clinical and procedural data including National Institute for Cardiovascular Outcomes Research derived outcome data from 1500 patients across five large congenital cardiology centres in the United Kingdom and Ireland were retrospectively collected. Catheterisation RISk score for Paediatrics were then calculated for each case and compared with the observed procedural outcomes. Chi-square analysis was used to determine the relationship between observed and predicted events.

Results:

Ninety-eight (6.6%) patients in this study experienced a significant complication as qualified by National Institute for Cardiovascular Outcomes Research classification. 4% experienced a moderate complication, 2.3% experienced a major complication and 0.3% experienced a catastrophic complication resulting in death. Calculated Catheterisation RISk score for Paediatrics scores correlated well with all observed adverse events for paediatric patients across all CRISP categories. The association was also transferable to adult congenital heart disease patients in lower Catheterisation RISk score for Paediatrics categories (CRISP 1–3).

Conclusion:

The Catheterisation RISk score for Paediatrics score accurately predicts significant complications in congenital catheterisation practice in the United Kingdom and Ireland. Our data validated the Catheterisation RISk score for Paediatrics assessment tool in five congenital centres using National Institute for Cardiovascular Outcomes Research-derived outcome data.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Gale, CP, Weston, C, Denaxas, S, et al. Engaging with the clinical data transparency initiative: a view from the National Institute for Cardiovascular Outcomes Research (NICOR). Heart Br Card Soc 2012; 98: 10401043.Google Scholar
Daabiss, M. American Society of Anaesthesiologists physical status classification. Indian J Anaesth 2011; 55: 111115.CrossRefGoogle ScholarPubMed
Lacour-Gayet, F, Clarke, D, Jacobs, J, et al. The Aristotle score for congenital heart surgery. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2004; 7: 185191.CrossRefGoogle ScholarPubMed
Learn, CP, Holzer, RJ, Daniels, CJ, et al. Adverse event rates and risk factors in adults undergoing cardiac catheterization at pediatric hospitals-results from C3PO. Catheter Cardiovasc Interv 2013; 81: 9971005.CrossRefGoogle Scholar
Chaudhry-Waterman, N, Coombs, S, Porras, D, Holzer, R, Bergersen, L. Developing tools to measure quality in congenital catheterization and interventions: the Congenital Cardiac Catheterization Project on Outcomes (C3PO). MDCVJ 2014; 10: 6367.Google Scholar
Bergersen, L, Gauvreau, K, Foerster, MSR, et al. Catheterization for Congenital Heart Disease Adjustment for Risk Method (CHARM). JACC Cardiovasc Interv 2011; 4: 10371046.CrossRefGoogle Scholar
Nykanen, DG, Forbes, TJ, Du, W, et al. CRISP: Catheterization RISk score for Pediatrics: a report from the Congenital Cardiac Interventional Study Consortium (CCISC). Catheter Cardiovasc Interv 2016; 87: 302309.CrossRefGoogle Scholar
Gilboa Suzanne, M, Devine Owen, J, Kucik James, E, et al. Congenital heart defects in the United States. Circulation 2016; 134: 101109.CrossRefGoogle Scholar
Hoffman, JI. The global burden of congenital heart disease. Cardiovasc J Afr 2013; 24: 141145.CrossRefGoogle ScholarPubMed
O’Leary, JM, Siddiqi, OK, de Ferranti, S, Landzberg, MJ, Opotowsky, AR. The changing demographics of congenital heart disease hospitalizations in the United States, 1998 Through 2010. JAMA 2013; 309: 984986.CrossRefGoogle ScholarPubMed
Dolk, H, Loane, M, Garne, E, a European Surveillance of Congenital Anomalies (EUROCAT) Working Group. Congenital heart defects in Europe. Circulation 2011; 123: 841849.CrossRefGoogle ScholarPubMed
NICOR. Congenital Heart Disease in Children and Adults (Congenital audit), 2021. Retrieved March 30, 2021, from https://www.nicor.org.uk/national-cardiac-audit-programme/congenital-heart-disease-in-children-and-adults-congenital-audit/.Google Scholar
Phillips, BL, Cabalka, AK, Hagler, DJ, Bailey, KR, Cetta, F. Procedural complications during congenital cardiac catheterization. Congenit Heart Dis 2010; 5: 118123.CrossRefGoogle ScholarPubMed
Mehta, R, Lee, K-J, Chaturvedi, R, Benson, L. Complications of pediatric cardiac catheterization: a review in the current era. Catheter Cardiovasc Interv 2008; 72: 278285.CrossRefGoogle ScholarPubMed
Bergersen, L, Gauvreau, K, Jenkins, KJ, Lock, JE. Adverse event rates in congenital cardiac catheterization: a new understanding of risks. Congenit Heart Dis 2008; 3: 90105.CrossRefGoogle ScholarPubMed
Stefanescu Schmidt, AC, Armstrong, A, Kennedy, KF, Nykanen, D, Aboulhosn, J, Bhatt, AB. Prediction of adverse events after catheter-based procedures in adolescents and adults with congenital heart disease in the IMPACT registry. Eur Heart J 2017; 38: 20702077.CrossRefGoogle ScholarPubMed
Taggart, NW, W., DU, Forbes, TJ, et al. A model for assessment of catheterization risk in adults with congenital heart disease. Am J Cardiol 2019; 123: 15271531.CrossRefGoogle Scholar
Heathfield, E, Hussain, T, Qureshi, S, et al. Cardiovascular magnetic resonance imaging in congenital heart disease as an alternative to diagnostic invasive cardiac catheterization: a single centre experience. Congenit Heart Dis 2013; 8: 322327.CrossRefGoogle Scholar
Crean, A. Cardiovascular MR and CT in congenital heart disease. Heart 2007; 93: 16371647.CrossRefGoogle ScholarPubMed
Hill, KD, Du, W, Fleming, GA, et al. Validation and refinement of the Catheterization RISk Score for Pediatrics (CRISP Score): an analysis from the Congenital Cardiac Interventional Study Consortium. Catheter Cardiovasc Interv 2019; 93: 97104.CrossRefGoogle ScholarPubMed
Crossland, DS, Van De Bruaene, A, Silversides, CK, Hickey, EJ, Roche, SL. Heart failure in adult congenital heart disease: from advanced therapies to end-of-life care. Can J Cardiol 2019; 35: 17231739.CrossRefGoogle ScholarPubMed
Jokinen, E. Coronary artery disease in patients with congenital heart defects. J Intern Med 2020; 288: 383389.CrossRefGoogle ScholarPubMed
Niwa, K. Metabolic syndrome in adult congenital heart disease. Korean Circ J 2019; 49: 691708.CrossRefGoogle ScholarPubMed
Dimopoulos, K, Diller, G-P, Koltsida, E, et al. Predictors, and prognostic value of renal dysfunction in adults with congenital heart disease. Circulation 2008; 117: 23202328.CrossRefGoogle ScholarPubMed