Use of CRISP Modifiers for Adults Undergoing Cardiac Catheterization Procedures: A Single Center Experience

The Catheterization RISk Score for Pediatrics (CRISP) has been validated and widely adopted as a model to predict adverse outcomes. We sought to determine if the addition of three modifiers (NYHA Class > 2, prior sternotomies > 2, and BMI > 30) to the CRISP score would better predict adverse events (AE) in adults undergoing cardiac catheterization at our institution. All adults (> 18 years) who underwent cardiac catheterization at the Children's Hospital Colorado from November 2016 to November 2021 were included. Baseline and modified CRISP scores with adult modifiers and AEs were analyzed. Of a total of 401 cases, there were 27 AEs (6.7%). A higher CRISP score was associated with an increased risk of AEs (p = 0.004). A ROC analysis of the CRISP score gave a AUC of 66% with a cut-off point of 5.5 giving a sensitivity of 74% and specificity of 52%. The modifiers individually did not significantly correlate with AEs. Higher modified CRISP score was similarly associated with an increased risk of AEs (p = 0.01). ROC analysis for the modified CRISP score gave an AUC of 64%. A cut-off point of 6.5 gave the best result with a sensitivity of 59% and specificity of 61%. A modified CRISP score which included adult modifiers similarly predicts AEs in adults with congenital heart disease. These adult modifiers are easy to incorporate into the CRISP score. The CRISP score also predicted AEs in adults with congenital heart disease.