Adverse events rates and risk factors in adults undergoing cardiac catheterization at pediatric hospitals—results from the C3PO. Issue 6 (23rd January 2013)

• Record Type: Journal Article
• Authors: Learn, Christopher P.; Holzer, Ralf J.; Daniels, Curt J.; Torres, Alejandro J.; Vincent, Julie A.; Moore, John W.; Armsby, Laurie B.; Landzberg, Michael J.; Bergersen, Lisa
• Is Part Of: Catheterization and cardiovascular interventions. Volume 81:Issue 6(2013:May 01)
• Page Start: 997
• Page End: 1005
• Publication Date: 2013-01-23
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.24658
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ccd24658-sec-0001" sec-type="section"> <title>Objective</title> <p>Determine the frequency and risk factors for adverse events (AE) for adults undergoing cardiac catheterization at pediatric hospitals.</p> </sec> <sec id="ccd24658-sec-0002" sec-type="section"> <title>Background</title> <p>Adult catheterization AE rates at pediatric hospitals are not well understood. The Congenital Cardiac Catheterization Project on Outcomes (C3PO) collects data on all catheterizations at eight pediatric institutions.</p> </sec> <sec id="ccd24658-sec-0003" sec-type="section"> <title>Methods</title> <p>Adult (≥18 years) case characteristics and AE were reviewed and compared with those of pediatric (<18 years) cases. Cases were classified into procedure risk categories from 1 to 4 based on highest risk procedure/intervention performed. AE were categorized by level of severity. Using a multivariate model for high severity AE (HSAE), standardized AE rates (SAER) were calculated by dividing the observed rates of HSAE by the expected rates.</p> </sec> <sec id="ccd24658-sec-0004" sec-type="section"> <title>Results</title> <p>2, 061 cases (15% of total) were performed on adults and 11, 422 cases (85%) were performed on children. Adults less frequently underwent high‐risk procedure category cases than children (19% vs. 30%). AE occurred in 10% of adult cases and 13% of pediatric cases (<italic>P</italic> < 0.001). HSAE occurred in 4% of adult and 5% of pediatric cases (<italic>P</italic> = 0.006). Procedure‐type risk category (Category 2, 3, 4 OR = 4.8, 6.0, 12.9) and systemic ventricle end diastolic pressure ≥ 18 mm Hg (OR 3.1) were associated with HSAE, <italic>c</italic> statistic 0.751. There were no statistically significant differences in SAER among institutions.</p> </sec> <sec id="ccd24658-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Adults undergoing catheterization at pediatric hospitals encountered AE less frequently than children did. The congenital heart disease adjustment for risk method for adults with congenital heart disease is a new tool for assessing procedural risk in adult patients. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>