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Prediction of Serious Adverse Events Associated With Pediatric Cardiac Catheterizations: External Model Validation of
Yoshihiko Kurita1, Rajiv Chaturvedi2, Lee Benson2
1Department of Pediatrics, Kochi Health Sciences Center, Kochi, Japan.
Insights
The Catheterization Risk Score for Pediatrics (CRISP) accurately predicts serious adverse events in pediatric cardiac catheterization. This validation supports better procedural planning and patient communication for improved care.
Area of Science:
- Pediatric Cardiology
- Medical Informatics
- Risk Stratification
Background:
- Predicting complications in pediatric cardiac catheterization is crucial for treatment planning, informed consent, and resource allocation.
- The Catheterization Risk Score for Pediatrics (CRISP) is a risk prediction tool for these procedures.
Purpose of the Study:
- To perform an external validation of the Catheterization Risk Score for Pediatrics (CRISP).
Main Methods:
- Retrospective review of 3093 pediatric catheterizations (January 2016 - March 2021).
- Calculation of CRISP scores and assessment of model performance using discrimination (AUC) and calibration.
Main Results:
- Serious adverse events (SAE) occurred in 6.5% of procedures.
- The CRISP score demonstrated good discriminative power (AUC 0.729) in identifying SAE.
- SAE incidence increased significantly with higher CRISP categories (1.5% in category 1 to 36.4% in category 5).
Conclusions:
- The CRISP scoring method shows good predictive performance for identifying serious adverse events.
- External validation supports the use of CRISP for procedural planning and enhancing patient safety.
- Improved risk prediction can enhance communication with patients and families, improving quality of care.
Background:
A methodology for predicting pediatric cardiac catheterization-related complications can assist interventionists in planning treatment strategies, obtaining informed consent, and allocating medical resources. We aimed to perform an external validation of the Catheterization Risk Score for Pediatrics (CRISP).
Methods:
We retrospectively reviewed 3093 consecutive catheterizations performed between January 2016 and March 2021 to calculate the CRISP. Model performance was assessed using discrimination (area under the receiver operating characteristic curve [AUC]) and calibration (observed and predicted risk).
Results:
Serious adverse events (SAE) occurred in 200 procedures (6.5%, 208 events). The most frequent complication was arterial occlusive thrombosis at the access site (1.8%). Nine catheterization-related deaths were identified. The mean CRISP score was 5.74 ± 3.43. SAE incidence increased across categories, ranging from 1.5% in category 1 to 36.4% in category 5. The CRISP score and categories demonstrated good discriminative power (AUC, 0.729; 95% CI, 0.695-0.764; AUC, 0.717, 95% CI, 0.682-0.752).
Conclusions:
The CRISP scoring method demonstrated good predictive performance in identifying SAE. This external validation supports procedural planning and may improve communication with patients and families, thereby enhancing safety and quality of care.
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