Key result
The Catheterisation RISk score for Paediatrics accurately predicted significant complications, which occurred in 6.6% of patients undergoing congenital cardiac catheterisation.
Why the study?
No established risk prediction tool exists in United Kingdom and Irish paediatric cardiology practice for patients undergoing cardiac catheterisation.
Does the Catheterisation RISk score for Paediatrics (CRISP) accurately predict complications in UK and Irish congenital catheterisation practice?
Observational (n=1,500)
Yes
Does the Catheterisation RISk score for Paediatrics (CRISP) accurately predict complications in UK and Irish congenital catheterisation practice?
The CRISP score is a valid tool for predicting procedural complications in pediatric and adult congenital heart disease patients undergoing cardiac catheterization in the UK and Ireland.
Supports CRISP for pre-procedural risk stratification in UK/Irish centres; extends North American validation but remains hypothesis-generating pending prospective data.
BACKGROUND: No established risk prediction tool exists in United Kingdom and Irish Paediatric Cardiology practice for patients undergoing cardiac catheterisation. The Catheterisation RISk score for Paediatrics is used primarily in North American practice to assess risk prior to cardiac catheterisation. Validating the utility and transferability of such a tool in practice provides the opportunity to employ an already established risk assessment tool in everyday practice. AIMS: To ascertain whether the Catheterisation RISk score for Paediatrics assessment tool can accurately predict complications within United Kingdom and Irish congenital catheterisation practice. METHODS: Clinical and procedural data including National Institute for Cardiovascular Outcomes Research derived outcome data from 1500 patients across five large congenital cardiology centres in the United Kingdom and Ireland were retrospectively collected. Catheterisation RISk score for Paediatrics were then calculated for each case and compared with the observed procedural outcomes. Chi-square analysis was used to determine the relationship between observed and predicted events. RESULTS: Ninety-eight (6.6%) patients in this study experienced a significant complication as qualified by National Institute for Cardiovascular Outcomes Research classification. 4% experienced a moderate complication, 2.3% experienced a major complication and 0.3% experienced a catastrophic complication resulting in death. Calculated Catheterisation RISk score for Paediatrics scores correlated well with all observed adverse events for paediatric patients across all CRISP categories. The association was also transferable to adult congenital heart disease patients in lower Catheterisation RISk score for Paediatrics categories (CRISP 1-3). CONCLUSION: The Catheterisation RISk score for Paediatrics score accurately predicts significant complications in congenital catheterisation practice in the United Kingdom and Ireland. Our data validated the Catheterisation RISk score for Paediatrics assessment tool in five congenital centres using National Institute for Cardiovascular Outcomes Research-derived outcome data.
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O’Callaghan et al. (2021) conducted an observational in congenital heart disease requiring cardiac catheterisation (n=1,500). Catheterisation RISk score for Paediatrics (CRISP) was evaluated on significant complications (moderate, major, or catastrophic). The Catheterisation RISk score for Paediatrics accurately predicted significant complications, which occurred in 6.6% of patients undergoing congenital cardiac catheterisation.
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