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CRISP: Catheterization RISk score for Pediatrics: A Report from the Congenital Cardiac Interventional Study
David G Nykanen1, Thomas J Forbes2, Wei Du3
1Arnold Palmer Hospital for Children and the University of Central Florida College of Medicine, Department of Pediatrics/Cardiology, Orlando, FL.
Insights
A new scoring system, the CRISP score, accurately predicts serious adverse events (SAEs) in pediatric cardiac catheterization. This tool aids in assessing individual patient risk for better procedural outcomes.
Area of Science:
- Pediatric Cardiology
- Medical Device Safety
- Risk Stratification
Background:
- Assessing serious adverse event (SAE) risk in pediatric cardiac catheterization is complex due to varied procedures, patient factors, and evolving technology.
- Existing risk assessment methods may not fully capture the nuances of individual patient vulnerability.
- A need exists for a validated tool to predict SAEs in this population.
Purpose of the Study:
- To develop and validate a predictive scoring system for serious adverse events (SAEs) in pediatric patients undergoing cardiac catheterization.
- To refine an initial expert-consensus risk score using real-world data for improved accuracy.
- To provide clinicians with a tool for individual patient risk assessment.
Main Methods:
- An initial 10-component scoring system was developed based on expert consensus and literature review.
- Data from an international pediatric cardiac catheterization registry (CCISC) (2008-2013) were utilized for validation.
- Multivariate analysis was employed to refine the original score and enhance its predictive capability for SAEs.
Main Results:
- All 10 components of the original risk score showed a significant correlation with SAEs in univariate analysis (P < 0.001).
- Multivariate analysis yielded a modified risk score, termed CRISP (Cardiac Risk in Pediatric Catheterization Score).
- The CRISP score improved the predictive accuracy, evidenced by an increase in the area under the receiver operating characteristic curve (AUC) from 0.715 to 0.741.
Conclusions:
- The developed CRISP score effectively predicts the risk of serious adverse events (SAEs) in individual pediatric patients.
- This validated tool can assist healthcare providers in identifying high-risk patients undergoing cardiac catheterization.
- The CRISP score offers a valuable advancement in the safety and risk management of pediatric cardiac procedures.
Objectives:
We sought to develop a scoring system that predicts the risk of serious adverse events (SAE's) for individual pediatric patients undergoing cardiac catheterization procedures.
Background:
Systematic assessment of risk of SAE in pediatric catheterization can be challenging in view of a wide variation in procedure and patient complexity as well as rapidly evolving technology.
Methods:
A 10 component scoring system was originally developed based on expert consensus and review of the existing literature. Data from an international multi-institutional catheterization registry (CCISC) between 2008 and 2013 were used to validate this scoring system. In addition we used multivariate methods to further refine the original risk score to improve its predictive power of SAE's.
Results:
Univariate analysis confirmed the strong correlation of each of the 10 components of the original risk score with SAE attributed to a pediatric cardiac catheterization (P < 0.001 for all variables). Multivariate analysis resulted in a modified risk score (CRISP) that corresponds to an increase in value of area under a receiver operating characteristic curve (AUC) from 0.715 to 0.741.
Conclusion:
The CRISP score predicts risk of occurrence of an SAE for individual patients undergoing pediatric cardiac catheterization procedures.
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