{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T01:13:55Z","timestamp":1787793235000,"version":"build-2784847793"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,1,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Advancements in the field, including novel procedures and multiple interventions, require an updated approach to accurately assess patient risk. This study aims to modernize patient hemodynamic and procedural risk classification through the creation of risk assessment tools to be used in congenital cardiac catheterization.<\/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                      Data were collected for all cases performed at sites participating in the C3PO (Congenital Cardiac Catheterization Project on Outcomes) multicenter registry. Between January 2014 and December 2017, 23\u00a0119 cases were recorded in 13 participating institutions, of which 88% of patients were &lt;18\u00a0years of age and 25% &lt;1\u00a0year of age; a high\u2010severity adverse event occurred in 1193 (5.2%). Case types were defined by procedure(s) performed and grouped on the basis of association with the outcome, high\u2010severity adverse event. Thirty\u2010four unique case types were determined and stratified into 6 risk categories. Six hemodynamic indicator variables were empirically assessed, and a novel hemodynamic vulnerability score was determined by the frequency of high\u2010severity adverse events. In a multivariable model, case\u2010type risk category (odds ratios for category: 0=0.46, 1=1.00, 2=1.40, 3=2.68, 4=3.64, and 5=5.25; all\n                      <jats:italic>P<\/jats:italic>\n                      \u22640.005) and hemodynamic vulnerability score (odds ratio for score: 0=1.00, 1=1.27, 2=1.89, and \u22653=2.03; all\n                      <jats:italic>P<\/jats:italic>\n                      \u22640.006) remained independent predictors of patient risk.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">These case\u2010type risk categories and the weighted hemodynamic vulnerability score both serve as independent predictors of patient risk for high\u2010severity adverse events. This contemporary procedure\u2010type risk metric and weighted hemodynamic vulnerability score will improve our understanding of patient and procedural outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.121.022832","type":"journal-article","created":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T06:37:17Z","timestamp":1640155037000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":50,"title":["Procedural Risk in Congenital Cardiac Catheterization (PREDIC\n                    <sup>3<\/sup>\n                    T)"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4440-2613","authenticated-orcid":false,"given":"Brian P.","family":"Quinn","sequence":"first","affiliation":[{"name":"Department of Cardiology Boston Children\u2019s Hospital Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9496-3462","authenticated-orcid":false,"given":"Mary","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children\u2019s Hospital Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberlee","family":"Gauvreau","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children\u2019s Hospital Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8899-7826","authenticated-orcid":false,"given":"Fatima","family":"Ali","sequence":"additional","affiliation":[{"name":"Section of Pediatric Cardiology Department of Pediatrics and Child Health The Aga Khan University Hospital Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Balzer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology St. Louis Children\u2019s Hospital St. Louis MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2726-7376","authenticated-orcid":false,"given":"Oliver","family":"Barry","sequence":"additional","affiliation":[{"name":"The Congenital Heart Center New York Presbyterian\/Morgan Stanley Children\u2019s Hospital New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8795-9526","authenticated-orcid":false,"given":"Sarosh","family":"Batlivala","sequence":"additional","affiliation":[{"name":"The Heart Institute Cincinnati Children\u2019s Hospital Cincinnati OH"},{"name":"Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren","family":"Berman","sequence":"additional","affiliation":[{"name":"The Heart Center Nationwide Children\u2019s Hospital Columbus OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2643-0730","authenticated-orcid":false,"given":"Susan","family":"Foerster","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Children\u2019s Wisconsin Milwaukee WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8508-9523","authenticated-orcid":false,"given":"Bryan","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Heart Institute UPMC Children\u2019s Hospital of Pittsburgh Pittsburgh PA"},{"name":"Department of Pediatrics University of Pittsburgh School of Medicine Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hainstock","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology University of Virginia Children\u2019s HospitalUniversity of Virginia Charlottesville VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2915-3724","authenticated-orcid":false,"given":"Ralf","family":"Holzer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Department of Pediatrics Weill Cornell Medicine New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Janssen","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology Monroe Carell Jr. Children\u2019s Hospital at Vanderbilt University Medical Center Nashville TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6023-1634","authenticated-orcid":false,"given":"Michael L.","family":"O\u2019Byrne","sequence":"additional","affiliation":[{"name":"Division of Cardiology Children\u2019s Hospital of Philadelphia Philadelphia PA"},{"name":"Department of Pediatrics Perelman School of Medicine at the University of Pennsylvania Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1661-6259","authenticated-orcid":false,"given":"Lauren","family":"Shirley","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children\u2019s Hospital Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Trucco","sequence":"additional","affiliation":[{"name":"Heart Institute UPMC Children\u2019s Hospital of Pittsburgh Pittsburgh PA"},{"name":"Department of Pediatrics University of Pittsburgh School of Medicine Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Whiteside","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology University of Michigan Medical School Ann Arbor MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Bergersen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston 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