Radiation Risk Categories in Cardiac Catheterization for Congenital Heart Disease: A Tool to Aid in the Evaluation of Radiation Outcomes. Pediatr Cardiol 2019 Feb;40(2):445-453
Date
12/07/2018Pubmed ID
30506273DOI
10.1007/s00246-018-2024-3Scopus ID
2-s2.0-85057871787 (requires institutional sign-in at Scopus site) 14 CitationsAbstract
To stratify diverse procedure types into categories with similar radiation exposure in cardiac catheterization for congenital heart disease. Radiation exposures for a comprehensive list of specific procedure types and stratification of outcomes based on radiation risk are not currently available. Data between January 2014 and December 2015 were collected on all cases performed at sites participating in C3PO-QI (Congenital Cardiac Catheterization Outcomes Project-Quality Improvement Initiative) and 9 centers were included. Using expert consensus, 40 unique procedure types were defined by diagnostic characteristics or the intervention(s) performed, and dose area product (DAP) per kilogram of body weight (µGy × m2/kg) was summarized. Using empiric and consensus methods, three radiation risk categories were created. A total of 11,735 cases were included for analysis. Thirteen (n = 7918) procedure types with median DAP/kg < 100 were categorized in the low radiation exposure category (median DAP/kg 39). The medium exposure category (n = 1807) consisted of 16 procedure types with median DAP/kg values ranging 100 to < 200 (overall median DAP/kg 131). Finally, the high radiation exposure category (n = 1073) consisted of 11 procedure types with median DAP/kg ≥ 200 (overall median DAP/kg of 231). The radiation exposure risk categories created in this multi-center dataset are a critical step towards the development of a robust risk adjustment methodology for radiation exposure in catheterization for congenital heart disease.
Author List
Quinn BP, Armstrong AK, Bauser-Heaton HD, Callahan R, El-Said HG, Foerster SR, Goldstein BH, Goodman AS, Gudausky TM, Kreutzer JN, Leahy RA, Petit CJ, Rockefeller TA, Shahanavaz S, Trucco SM, Bergersen L, Congenital Cardiac Catheterization Project on Outcomes-Quality Improvement (C3PO-QI)Authors
Susan Foerster MD Professor in the Pediatrics department at Medical College of WisconsinTodd M. Gudausky MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentCardiac Catheterization
Child
Child, Preschool
Consensus
Fluoroscopy
Heart Defects, Congenital
Humans
Infant
Prospective Studies
Quality Improvement
Radiation Dosage
Radiation Exposure
Radiography, Interventional
Risk Assessment
Risk Factors
Young Adult