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Adverse event rates in congenital cardiac catheterization — A multi‐center experience
Author(s) -
Bergersen Lisa,
Marshall Audrey,
Gauvreau Kimberlee,
Beekman Robert,
Hirsch Russel,
Foerster Susan,
Balzer David,
Vincent Julie,
Hellenbrand William,
Holzer Ralf,
Cheatham John,
Moore John,
Lock James,
Jenkins Kathy
Publication year - 2009
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.22266
Subject(s) - medicine , cardiac catheterization , incidence (geometry) , adverse effect , cohort , cath lab , retrospective cohort study , surgery , pediatrics , physics , myocardial infarction , conventional pci , optics
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.