Nykanen et al reported the CRISP (Catheterization Risk Score for Pediatrics) for predicting adverse events associated with catheterization of a pediatric patient with congenital heart disease. The authors are from multiple institutions in North America, South America and Europe belonging to the Congenital Cardiac Interventional Study Consortium (CCISC).
Patient selection: pediatric patient with congenital heart disease
Procedure: cardiac catheterization
Outcome: over 40 adverse events (Table II)
Parameters:
(1) age in years
(2) body weight
(3) inotropic support
(4) systemic illness or organ failure
(5) physiologic category (listed in on-line appendix III)
(6) pre-cath diagnosis (listed in on-line appendix I)
(7) procedure category (listed in on-line appendix II)
(8) procedure type
Parameter |
Finding |
Points |
age in years |
<= 1 year |
2 |
|
> 1 year |
0 |
weight |
<= 5 kg |
2 |
|
> 5 kg |
0 |
inotropic support |
none |
0 |
|
yes, stable |
0 |
|
yes, unstable or ECMO |
2 |
systemic illness or organ failure |
none |
0 |
|
medically controlled; 1 organ failure |
0 |
|
uncontrolled; > 1 organ failure |
3 |
physiologic category |
Category 1 |
0 |
|
Category 2 |
1 |
|
Category 3 |
4 |
pre-cath diagnosis |
Category 1 |
0 |
|
Category 2 |
2 |
|
Category 3 |
2 |
procedure category |
Category 1 |
0 |
|
Category 2 |
1 |
|
Category 3 |
3 |
procedure type |
diagnostic |
0 |
|
interventional |
3 |
|
hybrid |
4 |
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 21
• The higher the score the greater the risk for an adverse event.
Score |
Percent Adverse Event |
0 |
1% |
1 |
1/3% |
2 |
0.9% |
3 |
2% |
4 |
3.1% |
5 |
3.8% |
6 |
5.7% |
7 |
5.1% |
8 |
6.9% |
9 |
8.3% |
10 |
15.1% |
11 |
11.1% |
12 |
14.5% |
13 |
22.9% |
14 |
8.5% |
15 |
33.3% |
16 |
33.3% |
17 |
44.4% |
18 |
40% |
19 |
37.5% |
20 |
NA |
21 |
100% |
Performance:
• The area under the ROC curve is 0.74.
Specialty: Cardiology