A risk adjusted method for comparing adverse outcomes among practitioners in pediatric and congenital cardiac catheterization.

Congenital Heart Disease
Lisa BergersenKathy Jenkins

Abstract

We sought to develop a method to adjust for case mix diversity and allow comparison of adverse outcome rates among practitioners in pediatric and congenital cardiac catheterization. A single institutional database that captured demographic and procedural data was used to identify patient and procedural characteristics associated with adverse events (AE) and any high severity event classified as preventable or possibly preventable (P/PP). Diagnostic and procedural risk groups were created and indicators of hemodynamic vulnerability were defined. Expected event rates by the practitioners adjusting for case mix were calculated. Standardized adverse event ratios (SAER), defined as the observed rate divided by the expected rate for each practitioner were calculated with 95% confidence intervals. The database included 1727 hemodynamic (30%) and interventional (70%) cases performed by seven practitioners in 18 months. During 147 cases, at least one P/PP AE occurred; among the seven practitioners observed, event rates ranged from 3.2 to 14.2%. In multivariable analysis, risk factors for all P/PP events included highest procedure risk group (odds ratio [OR] 2.1 for group 2, and 2.8 for group 3, relative to group 1, P = .001 and P < .001...Continue Reading

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Citations

May 23, 2013·Cardiology in the Young·Patrícia Vaz SilvaAntónio Pires
Nov 4, 2015·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·David G NykanenUNKNOWN Congenital Cardiac Interventional Study Consortium (CCISC)
Feb 8, 2011·Revista española de cardiología·Georgia Sarquella-Brugada, Younes Boudjemline
Sep 24, 2011·JACC. Cardiovascular Interventions·Lisa BergersenKathy J Jenkins
Mar 9, 2017·Cardiology in the Young·Maren E A RavndalHenrik Holmstrøm
Mar 10, 2011·Circulation. Cardiovascular Interventions·Lisa BergersenKathy Jenkins
Dec 29, 2018·Paediatric Anaesthesia·Dima G DaaboulViviane G Nasr
Jun 25, 2019·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Javier J LasaUNKNOWN American Heart Association’s Get With the Guidelines-Resuscitation Investigators
Aug 23, 2021·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Michael L O'Byrne, Andrew C Glatz

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