Risk Factors Associated with Severe Adverse Events in Pediatric Cardiac Catheterization

Pediatric cardiac catheterization is a diagnostic and management tool for congenital heart diseases, offering several advantages over surgical procedures. However, it is not free from adverse events or complications. Despite its extensive use, the associated risk factors have not been adequately evaluated, particularly in Latin America. The objective of this study was to determine the risk factors associated with severe adverse events related to pediatric cardiac catheterization in a hospital in southwestern Colombia. Retrospective single-center study. Data from 986 patients under 18 years of age with congenital heart diseases who underwent cardiac catheterization between January 2018 and June 2023 were analyzed. Univariate, bivariate, and multivariate analyses were performed to identify the risk factors for severe adverse events. An incidence of severe adverse events of 2.07% was found, with unadjusted associations with the variables of type of procedure scheduling, diagnoses prompting the procedure, hemodynamic stability, ASA category, airway management before and during the procedure, and closure of intra- or extracardiac defects. Statistical significance was found in the multivariate analysis with the variables of type of procedure scheduling and hemodynamic stability, with the risk being 2.32 times (95% CI [1.14-4.96%]) and 2.96 times (95% CI [1.81-18.65%]), respectively. The type of procedure scheduling and hemodynamic stability prior to the procedure showed an association with severe adverse events in patients undergoing catheterization, indirectly informing the patient's physiological status. Achieving the highest possible clinical stability before performing the procedure is crucial.