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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

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