New NCDR Risk Stratification Tool Predicts Adverse Events For CHD Patients
A validated model that predicts adverse events after cardiac catheterization procedures in adolescents and adults with congenital heart disease (CHD) was presented Aug. 28 at ESC Congress 2016 in Rome.
Ada Stefanescu, MD, et al., used data from ACC’s IMPACT Registry to develop and validate the risk stratification tool. After adjusting for inclusion criteria, they examined 27,293 congenital cardiac catheterizations in patients over the age of 10, and found that the majority of patients were adolescents, had a moderate or complex diagnosis and an elective catheterization.
They further found that the “significant independent predictors” of adverse outcomes were higher index procedure risk, older age, having had no prior catheterization or surgeries, pre-procedural anticoagulation use, history of renal disease, lower hemoglobin, lower oxygen saturation, and a non-elective procedure. “The C-statistic for our model was robust at 0.752 in the derivation and 0.750 in the validation cohort,” they explain.
The authors conclude that “this model can be used to individualize the risk and benefit discussion in this special population prior to a catheterization procedure.” They add that moving forward, “creation of a user-friendly risk score and validation in another national or multi-institutional dataset are the next steps.”
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