6103 Development of a clinical predictive score for vascular complication in pediatric patients after cardiac catheterization

Objectives Cardiac catheterization serves as a primary diagnostic and therapeutic procedure. This crucial intervention is not without risks. Common concerns center on vascular access complications, including temporary loss of pulse, subcutaneous bleeding, hematoma, vessel tear, and thrombosis.¹ ² The objectives of this study aimed to determine the incidence rate and develop a prediction score for risk of vascular complication in pediatrics patients who undergoing cardiac catheterization. Methods A multivariable predictive model development study based on a retrospective cohort of patients performing cardiac catheterization was used in this study. The setting was an 800-bed public tertiary hospital including all children under 15 years of age who had cardiac catheterizations from January 2017 to December 2019. Data on complication rates, baseline demographics, and treatment modalities, including procedure types, were recorded in a database. The model was developed using logistic regression analysis. Predictor selection was conducted using a backward stepwise approach. Three risk groups were considered. Model performance was evaluated by area under the receiver operating characteristic curve, calibration, and classification measures. Results 429 patients were included; the complication incidence was 6.8%. The predictors were age, body weight, arterial and venous sheath per body weight/body surface area, type of catheterization, procedure-type risk categories ³ and use of slender sheath. The model had an area under the receiver operating characteristic curve of 0.81. The range of scores was 0 to 15. Patients were classified into three risk groups: low (score 0–7), middle (score 8–12) and high (score 13–15). The vascular complications after cardiac catheterization were reported 2.3% in low score group, 7.3% in middle score group and 22.7% in high score group. Conclusion Our scoring model had good predictive ability for vascular complications after cardiac catheterization in pediatric patient. References Roushdy AM, Abdelmonem N, El Fiky AA. Factors affecting vascular access complications in children undergoing congenital cardiac catheterization. 25 July 2011 22(2):136–44. Mehta R, Lee K-J, Chaturvedi R, Benson L. Complications of pediatric cardiac catheterization: a review in the current era. 10 June 2008 1;72(2):278–85. Natalie J, John A, Kevin F. Modeling major adverse outcomes of pediatric and adult patients with congenital heart disease undergoing cardiac catheterization. 7 Sep 2017. 136(21):2009–2019.