{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T07:43:44Z","timestamp":1781768624417,"version":"3.54.5"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,11,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Risk\u2010adjusted adverse event (\n              <jats:styled-content style=\"fixed-case\">AE<\/jats:styled-content>\n              ) rates have been used to measure the quality of pediatric and congenital cardiac catheterization laboratories. In other settings, failure to rescue (\n              <jats:styled-content style=\"fixed-case\">FTR<\/jats:styled-content>\n              ) has demonstrated utility as a quality metric.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A multicenter retrospective cohort study was performed using data from the IMPACT (Improving Adult and Congenital Treatment) Registry between January 2010 and December 2016. A modified\n              <jats:styled-content style=\"fixed-case\">FTR<\/jats:styled-content>\n              metric was developed for pediatric and congenital cardiac catheterization laboratories and then compared with pooled\n              <jats:styled-content style=\"fixed-case\">AEs<\/jats:styled-content>\n              . The associations between patient\u2010 and hospital\u2010level factors and outcomes were evaluated using hierarchical logistic regression models. Hospital risk standardized ratios were then calculated. Rankings of risk standardized ratios for each outcome were compared to determine whether\n              <jats:styled-content style=\"fixed-case\">AEs<\/jats:styled-content>\n              and\n              <jats:styled-content style=\"fixed-case\">FTR<\/jats:styled-content>\n              identified the same high\u2010 and low\u2010performing centers. During the study period, 77\u00a0580 catheterizations were performed at 91 hospitals. Higher annual hospital catheterization volume was associated with lower odds of\n              <jats:styled-content style=\"fixed-case\">FTR<\/jats:styled-content>\n              (odds ratio: 0.68 per 300 cases;\n              <jats:italic>P<\/jats:italic>\n              =0.0003). No association was seen between catheterization volume and odds of\n              <jats:styled-content style=\"fixed-case\">AEs<\/jats:styled-content>\n              . Odds of\n              <jats:styled-content style=\"fixed-case\">AEs<\/jats:styled-content>\n              were instead associated with patient\u2010 and procedure\u2010level factors. There was no correlation between risk standardized ratio ranks for\n              <jats:styled-content style=\"fixed-case\">FTR<\/jats:styled-content>\n              and pooled\n              <jats:styled-content style=\"fixed-case\">AEs<\/jats:styled-content>\n              (\n              <jats:italic>P<\/jats:italic>\n              =0.46). Hospital ranks by catheterization volume and\n              <jats:styled-content style=\"fixed-case\">FTR<\/jats:styled-content>\n              were associated (\n              <jats:italic>r<\/jats:italic>\n              =\u22120.28,\n              <jats:italic>P<\/jats:italic>\n              =0.01) with the largest volume hospitals having the lowest risk of\n              <jats:styled-content style=\"fixed-case\">FTR<\/jats:styled-content>\n              .\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In contrast to\n              <jats:styled-content style=\"fixed-case\">AEs<\/jats:styled-content>\n              ,\n              <jats:styled-content style=\"fixed-case\">FTR<\/jats:styled-content>\n              was not strongly associated with patient\u2010 and procedure\u2010level factors and was significantly associated with pediatric and congenital cardiac catheterization laboratory volume. Hospital rankings based on\n              <jats:styled-content style=\"fixed-case\">FTR<\/jats:styled-content>\n              and\n              <jats:styled-content style=\"fixed-case\">AEs<\/jats:styled-content>\n              were not significantly correlated. We conclude that\n              <jats:styled-content style=\"fixed-case\">FTR<\/jats:styled-content>\n              is a complementary measure of catheterization laboratory quality and should be included in future research and quality\u2010improvement projects.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.013151","type":"journal-article","created":{"date-parts":[[2019,10,17]],"date-time":"2019-10-17T09:02:07Z","timestamp":1571302927000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Failure to Rescue as an Outcome Metric for Pediatric and Congenital Cardiac Catheterization Laboratory Programs: Analysis of Data From the IMPACT Registry"],"prefix":"10.1161","volume":"8","author":[{"given":"Michael L.","family":"O'Byrne","sequence":"first","affiliation":[{"name":"Division of Cardiology Department of Pediatrics Perelman School of Medicine The Children's Hospital of Philadelphia University of Pennsylvania Philadelphia PA"},{"name":"Leonard Davis Institute University of Pennsylvania Philadelphia PA"},{"name":"Center for Cardiovascular Outcomes, Quality, and Evaluative Research University of Pennsylvania Philadelphia PA"},{"name":"Center for Pediatric Clinical Effectiveness The Children's Hospital of Philadelphia Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin F.","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Mid America Heart Institute St. Luke's Health System Kansas City MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Jayaram","sequence":"additional","affiliation":[{"name":"Mid America Heart Institute St. Luke's Health System Kansas City MO"},{"name":"Division of Cardiology Department of Pediatrics Children's Mercy Hospitals and Clinics Kansas City MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa J.","family":"Bergersen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children's Hospital Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Gillespie","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Pediatrics Perelman School of Medicine The Children's Hospital of Philadelphia University of Pennsylvania Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoav","family":"Dori","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Pediatrics Perelman School of Medicine The Children's Hospital of Philadelphia University of Pennsylvania Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey H.","family":"Silber","sequence":"additional","affiliation":[{"name":"Leonard Davis Institute University of Pennsylvania Philadelphia PA"},{"name":"Divisions of Hematology Oncology, Critical Care Medicine, and Outcomes Research Department of Pediatrics Perelman School of Medicine The Children's Hospital of Philadelphia University of Pennsylvania Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M.","family":"Kawut","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine Hospital of the University of Pennsylvania Department of Medicine Center for Clinical Epidemiology and Biostatistics Perelman School of Medicine The University of Pennsylvania Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan J.","family":"Rome","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Pediatrics Perelman School of Medicine The Children's Hospital of Philadelphia University of Pennsylvania Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew 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