# Prediction of Serious Adverse Events Associated With Pediatric Cardiac Catheterizations: External Model Validation of the CRISP Scoring Method

## TL;DR

This study validates a scoring system to predict serious complications in pediatric cardiac catheterizations, helping doctors plan treatments and improve patient safety.

## Contribution

The study provides an external validation of the CRISP scoring method for predicting complications in pediatric cardiac catheterizations.

## Key findings

- Serious adverse events occurred in 6.5% of procedures, with arterial occlusive thrombosis being the most frequent complication.
- The CRISP score showed good discriminative power with an AUC of 0.729 for predicting serious adverse events.

## Abstract

A methodology for predicting pediatric cardiac catheterization-related complications can assist interventionists in planning treatment strategies, obtaining informed consent, and allocating medical resources. We aimed to perform an external validation of the Catheterization Risk Score for Pediatrics (CRISP).

We retrospectively reviewed 3093 consecutive catheterizations performed between January 2016 and March 2021 to calculate the CRISP. Model performance was assessed using discrimination (area under the receiver operating characteristic curve [AUC]) and calibration (observed and predicted risk).

Serious adverse events (SAE) occurred in 200 procedures (6.5%, 208 events). The most frequent complication was arterial occlusive thrombosis at the access site (1.8%). Nine catheterization-related deaths were identified. The mean CRISP score was 5.74 ± 3.43. SAE incidence increased across categories, ranging from 1.5% in category 1 to 36.4% in category 5. The CRISP score and categories demonstrated good discriminative power (AUC, 0.729; 95% CI, 0.695-0.764; AUC, 0.717, 95% CI, 0.682-0.752).

The CRISP scoring method demonstrated good predictive performance in identifying SAE. This external validation supports procedural planning and may improve communication with patients and families, thereby enhancing safety and quality of care.