Santos Paulo Éden, Ballesteros Fernando, Rodríguez Alexandro, Zunzunegui José Luis
Paediatric Cardiology Department, Royal Manchester Children's Hospital - Manchester Foundation Trust, Manchester, Reino Unido Paediatric Cardiology Department Royal Manchester Children's Hospital - Manchester Foundation Trust Manchester Reino Unido.
Servicio de Cardiología Infantil, Centro Materno-Infantil - Hospital General Universitario Gregorio Marañón, Madrid, España Servicio de Cardiología Infantil Centro Materno-Infantil - Hospital General Universitario Gregorio Marañón Madrid España.
REC Interv Cardiol. 2023 Aug 9;6(1):20-24. doi: 10.24875/RECIC.M23000399. eCollection 2024 Jan-Mar.
Performing cardiac catheterization can be challenging regarding the management of congenital heart disease. Therefore, the use of risk scoring or grading systems can help us plan the procedure. Back in 2015, the Congenital Cardiac Interventional Study Consortium developed and validated a system called CRISP (Catheterization risk score for pediatrics), which predicted the risk of serious adverse events (SAEs) prior to cardiac catheterization. Our aim was to use and validate the same scoring system to predict SAEs associated with cardiac catheterization in a Spanish pediatric hospital.
A retrospective descriptive study was performed between January 2016 and May 2017. To create the area under the curve, the expected number of events was correlated with the overall number of cases (compared to the original CRISP). Pearson's chi-square test was used to assess the performance of the scoring system.
A total of 516 patients were successfully enrolled, 26.6% of whom were < 1 year-old [range, 1 day to 18 years], 56.5% were males, and 17% weighed < 5 kg. Around 63.3% of the procedures performed were percutaneous compared to 1.2% that were hybrid. A total of 40 SAEs were found to be amenable to immediate correction with no associated mortality. CRISP showed good discrimination with an area under the curve of 0.71 (95%CI, - 0.66-0.91) compared to the original score of 0.74, and adequate goodness of fit with Pearson's chi-square test of 8.26 ( < .08).
Despite the performance of highly complex procedures, the rate of SAEs was similar to the one previously published. CRISP has proven to be a good benchmarking and risk stratification tool. Therefore, it can be successfully used in the Spanish pediatric population and have a positive impact on patient care like helping during pre- and post-catheterization care planning.
在先天性心脏病的治疗中，进行心导管插入术可能具有挑战性。因此，使用风险评分或分级系统有助于我们规划手术。早在2015年，先天性心脏介入研究联盟就开发并验证了一个名为CRISP（儿科心导管插入术风险评分）的系统，该系统可预测心导管插入术前严重不良事件（SAE）的风险。我们的目的是使用并验证同一评分系统，以预测西班牙一家儿科医院与心导管插入术相关的SAE。
于2016年1月至2017年5月进行了一项回顾性描述性研究。为了创建曲线下面积，将预期事件数与病例总数相关联（与原始CRISP相比）。使用Pearson卡方检验来评估评分系统的性能。
共成功纳入516例患者，其中26.6%年龄小于1岁[范围为1天至18岁]，56.5%为男性，17%体重小于5kg。所进行的手术中约63.3%为经皮手术，相比之下，杂交手术占1.2%。共发现40例SAE可立即纠正，无相关死亡病例。与原始分数0.74相比，CRISP显示出良好的区分度，曲线下面积为0.71（95%CI，-0.66 - 0.91），并且通过Pearson卡方检验显示拟合优度良好，为8.26（<.08）。
尽管进行了高度复杂的手术，但SAE发生率与之前公布的相似。CRISP已被证明是一个良好的基准和风险分层工具。因此，它可以成功应用于西班牙儿科人群，并对患者护理产生积极影响，例如在导管插入术前和术后护理规划中提供帮助。
