Low weight as an independent risk factor for adverse events during cardiac catheterization of infants

Carl H. Backes, Clifford Cua, Jacqueline Kreutzer, Laurie Armsby, Howaida El-Said, John W. Moore, Kimberlee Gauvreau, Lisa Bergersen, Ralf J. Holzer

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

Background Studies have documented the importance of procedure type and hemodynamic variables on the incidence of procedure related adverse events (AE) after cardiac catheterization. However, little is known about the impact of low weight on the incidence and severity of AE. Methods: Data were prospectively collected using a multicenter registry (C3PO). Infants <1 year were divided into four weight categories: <2 kg, 2-3 kg, 3-5 kg, ≥5 kg. AE severity was classified as level 1-5 (none, minor, moderate, major, death). Results Eight centers submitted details on 3,679 cases (34% diagnostic) performed in infants <1 year from 2/07 to 6/10: <2 kg: 57 (1.5%), 2-3 kg: 403 (11%), 3-5 kg: 1,527 (41.5%), ≥5 kg: 1,692 (46%). AE occurred in 20% of cases (<2 kg: 28%, 2-3 kg: 25%, 3-5 kg: 23%, ≥5 kg: 16%) with 41% of all AE being level 3-5 AE. Death occurred more frequently in the <2 kg group (12%), 71% of which were interventional cases. The case-related mortality in all other weight groups was <1%. By multivariable analysis, weight <2 kg, 2-3 kg, and 3-5 kg were independent risk factors for high severity (level 3-5) AE (<2 kg: OR 2, 95%CI 1.1-3.6; 2-3 kg: OR 1.4, 95%CI 1-1.8; 3-5 kg: OR 1.3, 95%CI 1.1-1.5), with similar findings for all AE. Blood transfusions were more common in lower weight categories (<2 kg: 42%, 2-3 kg: 29%, 3-5 kg: 25%, ≥5 kg: 15%, p<0.001). Conclusions: The risk of AE during cardiac catheterization of infants increases with lower weight. Infants who weigh less than 2 kg have a significantly higher risk of adverse events (most notably death) even after correcting for hemodynamic vulnerability and procedure type risk group.

Original languageEnglish (US)
Pages (from-to)786-794
Number of pages9
JournalCatheterization and Cardiovascular Interventions
Volume82
Issue number5
DOIs
StatePublished - Nov 1 2013

Keywords

  • CATH
  • PEDS
  • complications pediatric cath/intervention
  • diagnostic cardiac catheterization
  • pCOMP
  • pediatric interventions

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Backes, C. H., Cua, C., Kreutzer, J., Armsby, L., El-Said, H., Moore, J. W., Gauvreau, K., Bergersen, L., & Holzer, R. J. (2013). Low weight as an independent risk factor for adverse events during cardiac catheterization of infants. Catheterization and Cardiovascular Interventions, 82(5), 786-794. https://doi.org/10.1002/ccd.24726