NCDR Update: New NCDR Risk Stratification Tool Predicts Adverse Events For CHD Patients
CardioSource WorldNews Interventions | A validated model that predicts adverse events after cardiac catheterization procedures in adolescents and adults with congenital heart disease (CHD) was presented at ESC Congress 2016 in Rome.
Ada Stefanescu, MD, et al., used data from ACC’s NCDR 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.”
NCDR LAAO Registry Approved By CMS to Meet NCD Requirements
The Centers for Medicare and Medicaid Services (CMS) has identified the LAAO Registry™ as an approved registry to meet the requirements of the national coverage determination (NCD) for Medicare patients undergoing percutaneous left atrial appendage closure.
Launched in December 2015, the LAAO Registry is the first national registry capturing data on left atrial appendage occlusion procedures to assess real-world procedural outcomes, short and long-term safety, comparative effectiveness and cost effectiveness. Patient-level data will be submitted by participating hospitals on a quarterly basis to ACC’s NCDR.
Physicians and hospitals can use these data to support quality improvement efforts locally and monitor patterns of care. Registry data will be used to help develop clinical guidelines leading to improved patient care. Ultimately, the registry will provide a better understanding of this population and emerging treatment options.
For more information, visit ACC.org/LAAORegistry. CMS’ registry approval is posted on CMS’ website.
|Read the full September/October issue of CardioSource WorldNews Interventions at ACC.org/CSWNI|
Keywords: CardioSource WorldNews Interventions, National Cardiovascular Data Registries, IMPACT Registry, Atrial Appendage, Cardiac Catheterization, Centers for Medicare and Medicaid Services, U.S., Heart Defects, Congenital, Hemoglobins, Medicaid, Medicare, Registries
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