title: CRISP: Catheterization RISk score for Pediatrics: A Report from the Congenital Cardiac Interventional Study Consortium (CCISC).
abstract: OBJECTIVE
  We sought to develop a scoring system that predicts the risk of serious adverse events (SAE's) for individual pediatric patients undergoing cardiac catheterization procedures.
  
  
  BACKGROUND
  Systematic assessment of risk of SAE in pediatric catheterization can be challenging in view of a wide variation in procedure and patient complexity as well as rapidly evolving technology.
  
  
  METHODS
  A 10 component scoring system was originally developed based on expert consensus and review of the existing literature. Data from an international multi-institutional catheterization registry (CCISC) between 2008 and 2013 were used to validate this scoring system. In addition we used multivariate methods to further refine the original risk score to improve its predictive power of SAE's.
  
  
  RESULTS
  Univariate analysis confirmed the strong correlation of each of the 10 components of the original risk score with SAE attributed to a pediatric cardiac catheterization (P < 0.001 for all variables). Multivariate analysis resulted in a modified risk score (CRISP) that corresponds to an increase in value of area under a receiver operating characteristic curve (AUC) from 0.715 to 0.741.
  
  
  CONCLUSIONS
  The CRISP score predicts risk of occurrence of an SAE for individual patients undergoing pediatric cardiac catheterization procedures.
authors.affiliation: Arnold Palmer Hospital for Children and the University of Central Florida College of Medicine, Department of Pediatrics/Cardiology, Orlando, FL.
authors.forename: David G
authors.initials: DG
authors.lastname: Nykanen
authors.affiliation: Children's Hospital of Michigan, Department of Pediatrics/Cardiology, Detroit, Michigan.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Forbes
authors.affiliation: Wayne State University, Department of Pediatrics, Pharmacology, Detroit, Michigan.
authors.forename: Wei
authors.initials: W
authors.lastname: Du
authors.affiliation: University of Iowa Children's Hospital, Department of Pediatrics/Cardiology, Iowa City, Iowa.
authors.forename: Abhay A
authors.initials: AA
authors.lastname: Divekar
authors.affiliation: University of Georgia, Department of Statistics, Athens, Georgia.
authors.forename: Jaxk H
authors.initials: JH
authors.lastname: Reeves
authors.affiliation: Mayo Clinic, Department of Pediatrics/Cardiology, Rochester, Minnesota.
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Hagler
authors.affiliation: University of Colorado, Department of Pediatrics/Cardiology, Denver.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Fagan
authors.affiliation: Instituto Dante Pazzanese De Cardiologia and Hospital Do Coração Da Associação Sanatório Sírio, Department of Pediatrics/Cardiology, São Paulo, Brazil.
authors.forename: Carlos A C
authors.initials: CA
authors.lastname: Pedra
authors.affiliation: Duke University, Department of Pediatrics/Cardiology, Durham, North Carolina.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Fleming
authors.affiliation: Miami Children's Hospital, Department of Pediatrics/Cardiology, Miami, Florida.
authors.forename: Danyal M
authors.initials: DM
authors.lastname: Khan
authors.affiliation: Advocate Children's Hospital and the University of Illinois, Department of Pediatrics/Cardiology, Oak Lawn, Illinois.
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Javois
authors.affiliation: University of Minnesota Amplatz Children's Hospital, Department of Pediatrics/Cardiology, Minneapolis, Minneapolis.
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Gruenstein
authors.affiliation: Evelina London Children's Hospital, London, Department of Paediatrics/Cardiology, United Kingdom.
authors.forename: Shakeel A
authors.initials: SA
authors.lastname: Qureshi
authors.affiliation: University of California San Francisco, Department of Pediatrics/Cardiology, San Francisco, CA.
authors.forename: Phillip M
authors.initials: PM
authors.lastname: Moore
authors.affiliation: Ann and Robert H. Lurie Children's Hospital, Department of Pediatrics/Cardiology, Chicago, Illinois.
authors.forename: David H
authors.initials: DH
authors.lastname: Wax
mesh_terms: D000293:Adolescent; D000367:Age Factors; D019540:Area Under Curve; D006328:Cardiac Catheterization / Q000009:adverse effects*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003661:Decision Support Techniques; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D015999:Multivariate Analysis; D010372:Pediatrics / Q000379:methods*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012042:Registries; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
keywords: COMP - complications; pediatric catheterization/intervention