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[Adverse events during diagnostic and therapeutic pediatric cardiac catheterization]
Armando Zepeda-Arámbula1, Lorenzo Gutiérrez-Cobian, Jorge Luis Villatoro-Fernández
1Departamento de Pediatría Médica, Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México. albtlacuilo@yahoo.com.
Insights
Pediatric cardiac catheterization is a safe procedure with a 13% adverse event rate. Key risk factors include young age, unscheduled admissions, and inotropic drug use.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
Background:
- Assessing adverse event frequency in pediatric cardiac catheterization is crucial.
- Understanding risks in both diagnostic and therapeutic procedures is needed.
Purpose of the Study:
- Determine the frequency of adverse events in pediatric heart catheterization.
- Analyze adverse events in diagnostic versus therapeutic cardiac catheterization.
Main Methods:
- Retrospective review of clinical charts from May 1 to October 31, 2014.
- Inclusion criteria applied to 126 out of 143 performed procedures.
- Adverse events within 24 hours post-procedure were recorded.
Main Results:
- Overall adverse event rate was 13% (16/126 patients).
- Diagnostic procedures had an 11.7% adverse event rate; therapeutic procedures had 14%.
- Serious adverse events occurred in 5.5%, life-threatening in 3.9%, and catastrophic in 0.79%.
Conclusions:
- Pediatric cardiac catheterization at this facility is safe, with rates comparable to global data.
- Comprehensive patient assessment, risk stratification, and gravity assessment are vital.
- Younger age (<1 year), unscheduled admission, and inotropic drug use are associated with increased adverse event risk.
Background:
The aim of this paper is to determine the frequency of adverse events during heart catheterization, in both categories diagnostic and therapeutic procedures in children.
Methods:
We review the clinical charts of those patients undergoing heart catheterization during the period from May 1 to October 31, 2014, in order to determine the frequency of adverse events presented within the first 24 hours after the procedure.
Results:
During the six month period, 143 procedures were performed, of which 126 met the inclusion criteria. According to the type of procedure we divide it in: diagnostic 68 (54%) and therapeutic 58 (46%). Adverse effects were developed in 16 patients (13%), 11.7% during diagnostic and 14% within the therapeutic procedures. The adverse events were classified as serious in 7 (5.5%), endangering the live in 5 (3.9%) and catastrophic in only one (0.79%). Those factors associated with the development of an adverse event were: age less than one year-old (OR = 5.45), unscheduled admission to the procedure (OR = 1.2) and use of inotropic drugs (OR = 7).
Conclusions:
Cardiac catheterization performed in our facility is a safe procedure, with a percentage of adverse events similar to that reported worldwide. It is essential to make a proper and comprehensive assessment of the patient before the procedure, considering stratification according to risk categories and assessing the state of gravity of the children.
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