Use of a pediatric risk score for cardiac catheterization in a Spanish population with congenital heart disease

Abstract

Introduction and objectives: Performing cardiac catheterization can be challenging regarding the management of congenital heart disease. Therefore, the use of risk scoring or grading systems can help us plan the procedure. Back in 2015, the Congenital Cardiac Interventional Study Consortium developed and validated a system called CRISP (Catheterization risk score for pediatrics), which predicted the risk of serious adverse events (SAEs) prior to cardiac catheterization. Our aim was to use and validate the same scoring system to predict SAEs associated with cardiac catheterization in a Spanish pediatric hospital. Methods: A retrospective descriptive study was performed between January 2016 and May 2017. To create the area under the curve, the expected number of events was correlated with the overall number of cases (compared to the original CRISP). Pearson’s chi-square test was used to assess the performance of the scoring system. Results: A total of 516 patients were successfully enrolled, 26.6% of whom were < 1 year-old [range, 1 day to 18 years], 56.5% were males, and 17% weighed < 5 kg. Around 63.3% of the procedures performed were percutaneous compared to 1.2% that were hybrid. A total of 40 SAEs were found to be amenable to immediate correction with no associated mortality. CRISP showed good discrimination with an area under the curve of 0.71 (95%CI, - 0.66-0.91) compared to the original score of 0.74, and adequate goodness of fit with Pearson’s chi-square test of 8.26 ( P < .08). Conclusions: Despite the performance of highly complex procedures, the rate of SAEs was similar to the one previously published. CRISP has proven to be a good benchmarking and risk stratification tool. Therefore, it can be successfully used in the Spanish pediatric population and have a positive impact on patient care like helping during pre-and post-catheterization care planning.