Interventional cardiac catheterization had a significantly higher incidence of adverse events compared to diagnostic cases (20% vs 10%, p<0.001).
Cohort (n=3,855)
Yes
Does interventional cardiac catheterization have higher adverse event rates compared to diagnostic catheterization in patients with congenital heart disease?
Interventional cardiac catheterization in congenital heart disease is associated with a significantly higher incidence of adverse events compared to diagnostic procedures, highlighting the need for risk adjustment in institutional comparisons.
Absolute Event Rate: 20% vs 10%
p-value: p=<0.001
OBJECTIVES: To describe case mix variation among institutions, and report adverse event rates in congenital cardiac catheterization by case type. BACKGROUND: Reported adverse event rates for patients with congenital heart disease undergoing cardiac catheterization vary considerably, due to non-comparable standards of data inclusion, and highly variable case mix. METHODS: The Congenital Cardiac Catheterization Outcomes Project (C3PO) has been capturing case characteristics and adverse events (AE) for all cardiac catheterizations performed at six pediatric institutions. Validity and completeness of data were independently audited. RESULTS: Between 2/1/07 and 4/30/08, 3855 cases (670 biopsy, 1037 diagnostic, and 2148 interventional) were recorded, median number of cases per site 480 (308 to 1526). General anesthesia was used in 70% of cases (28 to 99%), and 22% of cases (15 to 26%) were non-electively or emergently performed. Three institutions performed a higher proportion of interventions during a case, 72 to 77% compared to 56 to 58%. The median rate of AE reported per institution was 16%, ranging from 5 to 18%. For interventional cases the median rate of AE reported per institution was 19% (7 to 25%) compared to 10% for diagnostic cases (6 to 16%). The incidence of AE was significantly higher for interventional compared to diagnostic cases (20% vs 10%, p<0.001), as was the incidence of higher severity AE (9% vs 5%, p<0.001). Adverse events in biopsy cases were uncommon. CONCLUSIONS: In this multi-institutional cohort, the incidence of AE is higher among interventional compared to diagnostic cases, and is very low among biopsy cases. Equitable comparisons among institutions will require the development and application of risk adjustment methods.
Bergersen et al. (2009) conducted a cohort in Congenital heart disease (n=3,855). Interventional cardiac catheterization vs. Diagnostic cardiac catheterization was evaluated on Adverse events (p=<0.001). Interventional cardiac catheterization had a significantly higher incidence of adverse events compared to diagnostic cases (20% vs 10%, p<0.001).