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.
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