Risk factors for adverse events during cardiovascular magnetic resonance in congenital heart disease.
OBJECTIVE
To assess the incidence and severity of adverse events (AE) associated with cardiovascular magnetic resonance (CMR) in a large cohort of patients with congenital heart disease and to identify independent risk factors for their occurrence.


METHODS
AEs were prospectively recorded from October 2002 through December 2004 and graded by 3 independent observers for severity, preventability, and attributability. The rate of adverse events was analyzed for each candidate variable using Fisher's exact test and independent predictors were identified by multiple logistic regression analysis.


RESULTS
There were 22 AEs among 1334 CMR studies (1.6%); 14 (63.5%) minor, 7 (32%) moderate, and 1 (4.5%) major. General anesthesia (GA) was used in 274 studies (20.5%) with 12 AEs (4.4%, p<0.001). There were 7 AEs (6.3%, p=0.001) in 112 studies on hospitalized patients, 5 AEs (5.2%, p=0.018) in 97 patients under 1 year of age, and 3 AEs (2.2%, p=0.479) in 134 patients with functional single ventricle. The highest rate of AEs was noted in inpatients under GA (10.4%, p<0.001); most were in the intensive care unit. Use of anesthesia (OR 3.91 [95% CI 1.46, 10.48] p=0.007) and inpatient status (OR 3.56 [95% CI 1.16, 10.89], p=0.026) were independent predictors of AEs.


CONCLUSIONS
CMR in patients with congenital heart disease has a low rate of AEs. Use of GA and examinations on hospitalized patients are independent risk factors for AEs with the most acutely ill patients at highest risk.
Dorfman
Adam L
AL
Department of Cardiology, Children's Hospital Boston and Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA.
Odegard
Kirsten C
KC
Powell
Andrew J
AJ
Laussen
Peter C
PC
Geva
Tal
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000768:Anesthesia, General / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D005682:Gadolinium / Q000009:adverse effects*; D006304:Health Status; D006330:Heart Defects, Congenital / Q000175:diagnosis*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007297:Inpatients; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D012107:Research Design; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index
D003287:Contrast Media; D005682:Gadolinium