Author + information
- Tiago Adrega1
The implementation of quality control measures is of paramount importance in health care setting, gaining particular interest in paediatric populations with heart disease. Nonetheless, objective measuring tools are frequently missing or are cumbersome to implement. We sought to evaluate all the cardiac catheterisation procedures occurred in the last 3 years in our paediatric tertiary centre and, simultaneously, validate a simple risk scoring system to our population and compare its predictive accuracy with the original score.
It is a single-centre retrospective study, embracing patients under 18 years-old undergoing cardiac catheterisation in a university hospital, between January 2013 and May 2016. The 2016 Catheterization RISk Score for Pediatrics (CRISP) was used to compare the predicted and occurred serious adverse events (SAE’s). The area under the receiver operating characteristic curve (ROC) and Hosmer-Lemeshow test were used to assess the test performance.
A total of 377 consecutive patients were included, with a median age of 78 months [Q1 28 and Q3 152], 48% female and 51% of the procedures resulted in a percutaneous intervention. There were 12 (3.1%) Serious Adverse Events (SAE’s), versus the predicted 2.8% and the mortality rate was 0%. All of the SAE’s were amenable of immediate correction without added morbidity. Additionally, regarding the procedures where the centre had more experience, the observed SAE rate was inferior than the expected. The score exhibited a good discrimination power, with an area under the ROC curve of 0.79 (CI 0.66 to 0.91) similar to the original score (0.74) and an appropriate goodness of fit, with a Hosmer-Lemeshow test of 0.62.
Quality assessment tools were easy to implement, highlighted opportunities for improvement and enabled the validation of a tailored risk scoring tool for this paediatric population.
STRUCTURAL: Congenital and Other Structural Heart Disease