Abstract
Background: We sought to determine the rate of adverse events in pediatric cardiac catheterization procedures and determine patient and procedural characteristics predictive of events.
Methods: A prospective database was created to record patient and procedural characteristics and adverse events. Procedures were grouped into 5 categories based on anticipated risk.
Results: In 9 months, 791 procedures were performed and most involved at least one intervention (81%). Ages at procedures were: < 1 mo (4%); 1mo to 1 yr (16%); 1 to 2 yrs (14%); and > 3 yrs (66%). Procedures were electively scheduled in 78%. An indicator of vulnerable hemodynamics was present in 38% of cases including elevated pulmonary or right ventricular pressures > systemic, cyanosis (saturation <75%), or low CI (< 2.0 L/min/m2). The lowest anticipated procedural risk group comprised the largest proportion of procedures (group 1, 47%; 2, 32%; 3, 9%; 4, 9%; 5, 3%). At least 1 adverse event occurred in 22.8% of procedures: serious life threatening events (2%), events requiring significant intervention (6 %), and minor events (17 %). Adverse events were significantly more likely to occur in younger patients (37% < 3 yrs vs. 15% > 3yrs, p<0.001) and in those with an indicator of physiologic vulnerability (33% vs 14%, p <0.001). Adverse events were less common in outpatient procedures than inpatient and emergent procedures (8% vs 25% and 33%, p <0.001). Interventional procedures (25% vs 15%, p = 0.01) and higher procedural risk group were associated with increasing complication rates (11% in 1, 26% in 2, 39% in 3, 50% in 4, 44% in 5, p <0.001).
Conclusion: These data provide current estimates of adverse event rates in pediatric catheterization and identify high risk patient and procedural characteristics.
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Bergersen, L., Nugent, A., Keane, J. et al. 35 Adverse Event Rates for Pediatric Cardiac Catheterization Procedures: Identification of High-Risk Populations. Pediatr Res 58, 360 (2005). https://doi.org/10.1203/00006450-200508000-00064
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DOI: https://doi.org/10.1203/00006450-200508000-00064