CRISP: Catheterization RISk score for pediatrics: A Report from the Congenital Cardiac Interventional Study Consortium (CCISC)

Abstract

Objectives: We sought to develop a scoring system that predicts the risk of serious adverse events (SAE's) for individual pediatric patients undergoing cardiac catheterization procedures. Background: Systematic assessment of risk of SAE in pediatric catheterization can be challenging in view of a wide variation in procedure and patient complexity as well as rapidly evolving technology. Methods: A 10 component scoring system was originally developed based on expert consensus and review of the existing literature. Data from an international multi-institutional catheterization registry (CCISC) between 2008 and 2013 were used to validate this scoring system. In addition we used multivariate methods to further refine the original risk score to improve its predictive power of SAE's. Results: Univariate analysis confirmed the strong correlation of each of the 10 components of the original risk score with SAE attributed to a pediatric cardiac catheterization (P < 0.001 for all variables). Multivariate analysis resulted in a modified risk score (CRISP) that corresponds to an increase in value of area under a receiver operating characteristic curve (AUC) from 0.715 to 0.741. Conclusion: The CRISP score predicts risk of occurrence of an SAE for individual patients undergoing pediatric cardiac catheterization procedures. V C 2015 Wiley Periodicals, Inc.

Acute and mid‐term outcomes of stent implantation for recurrent coarctation of the aorta between the Norwood operation and fontan completion: A multi‐center Pediatric Interventional Cardiology Early Career Society Investigation

“…Procedural success was defined as a post intervention peak‐to‐peak gradient across the aortic arch gradient of ≤ 10 mm Hg . Serious adverse events (SAE) were recorded and defined based on published literature on catheterization risk score for pediatrics . Hemodynamic compromise was defined as hemodynamic instability requiring an intervention (for example, inotropic medication, or cardiopulmonary resuscitation).…”

Anesthesia for high‐risk procedures in the catheterization laboratory

“…Concurrent with development of the CHARM model, the CCISC group developed the Catheterization RIsk Score for Pediatrics (CRISP) collecting data from pediatric cardiac catheterizations from 20 international centers . CRISP assigns points based on patient's age, weight, inotropic support/extracorporeal membrane oxygenator (ECMO), systemic illness/organ failure, physiological status (based on arterial saturation, pulmonary vascular resistance index, right ventricle pressure, anemia/bleeding, cyanotic episodes, atrioventricular valve regurgitation), precatheterization diagnosis, procedure type (diagnostic, interventional, hybrid), and the procedure performed.…”

“…They further simplified the scoring system by assigning patients into one of five CRISP categories, which would define their individual risk for serious adverse events. The risk of serious adverse events ranges from 1% for CRISP 1 to 36.8% for CRISP 5 …”

Pediatric and Adolescent Pulmonary Hypertension: What Is the Risk of Undergoing Invasive Hemodynamic Testing?

“…Both single‐center and pooled registry data have shown that children with PH undergoing HC have a high risk of major AEs (3.5%–6.2%) and death (0.2%–1.4%) 4, 6, 7, 8, 9, 10, 11, 12, 13, 14. However, there are limited data identifying important risk factors for major AE and death in the pediatric PH population.…”

“…Risk factors: patient status (emergent/urgent), age (<30 d),weight (<2.5 kg), ionotrope use, respiratory failure on mechanical ventilation, systemic illness/failure, physiologic category,14 precatheterization diagnosis risk stratification,14 ASA score…”