Relationship Between Hospital Procedure Volume and Complications Following Congenital Cardiac Catheterization: A Report from The IMPACT® Registry

Background The association between institutional volume and outcomes has been demonstrated for cardiac catheterization among adults, but less is known about this relationship for patients with congenital heart disease (CHD) undergoing cardiac catheterization. Methods Within the IMPACT® (Improving Pediatric and Adult Congenital Treatment) Registry, we identified all catheterizations between January 2011 and March 2015. Hierarchical logistic regression, adjusted for patient and procedural characteristics, was used to determine the association between annual catheterization lab volume and occurrence of a major adverse event (MAE). Results Of 56,453 catheterizations at 77 hospitals, an MAE occurred in 1014 (1.8%) of cases. In unadjusted analysis, an MAE occurred in 2.8% (123/4460) of cases at low-volume hospitals (