Creation of a Risk Adjustment Model for Adverse Events after Congenital Cardiac Catheterization

Background: As US healthcare increasingly focuses upon outcomes to quantify quality, there is a growing demand for risk models that can account for patient variability at different hospitals so that equitable comparison between institutions can be made. We developed a method for risk-standardizing adverse outcomes following congenital cardiac catheterization. Methods: Using the national, multicenter, IMPACT® (Improving Pediatric and Adult Congenital Treatment) Registry, all patients undergoing diagnostic or interventional cardiac catheterization between January 2011 and March 2013 were identified. Multivariable hierarchical logistic regression was used to identify patient and procedural characteristics predictive of experiencing a major adverse event (see Figure) following cardiac catheterization. Results: A total of 19,608 cardiac catheterizations were performed between January 2011 and March 2013. Among all cases, a major adverse event occurred in 378 (1.9%). After multivariable adjustment, 8 variables ...