Development of mortality prediction models for infants with isolated, left-sided congenital diaphragmatic hernia before and after birth.

Autor: Yoneda K; Division of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Setagaya-ku, Japan., Amari S; Division of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Setagaya-ku, Japan., Mikami M; Division of Biostatistics, Clinical Research Center, National Center for Child Health and Development, Setagaya-ku, Japan., Uchida K; Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Japan., Yokoi A; Department of Pediatric Surgery, Kobe Children's Hospital, Kobe, Japan., Okawada M; Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan., Furukawa T; Department of Pediatric Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan., Toyoshima K; Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan., Inamura N; Department of Pediatrics, Kindai University, Faculty of Medicine, Osaka-Sayama, Japan., Okazaki T; Department of Pediatric Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan., Yamoto M; Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan., Masumoto K; Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan., Terui K; Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan., Okuyama H; Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita, Japan., Hayakawa M; Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan., Taguchi T; Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.; Fukuoka College of Health Sciences, Fukuoka, Japan., Usui N; Department of Pediatric Surgery, Osaka Women's and Children's Hospital, Izumi, Japan., Isayama T; Division of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Setagaya-ku, Japan.
Jazyk: angličtina
Zdroj: Pediatric pulmonology [Pediatr Pulmonol] 2023 Jan; Vol. 58 (1), pp. 152-160. Date of Electronic Publication: 2022 Oct 11.
DOI: 10.1002/ppul.26172
Abstrakt: Background: Mortality prediction of congenital diaphragmatic hernia (CDH) is essential for developing treatment strategies, including fetal therapy. Several researchers have reported prognostic factors for this rare but life-threatening condition; however, the optimal combination of prognostic factors remains to be elucidated.
Objectives: This study aimed to develop the most discriminative prenatal and postnatal models to predict the mortality of infants with an isolated left-sided CDH.
Methods: This multi-institutional retrospective cohort study included infants with CDH born at 15 tertiary hospitals of the Japanese CDH Study Group between 2011 and 2016. We developed multivariable logistic models with every possible combination of predictors and identified models with the highest cross-validated area under the receiver operating characteristic curve (AUC) for prenatal and postnatal predictions.
Results: Among 302 eligible infants, 44 died before discharge. The prenatal mortality prediction model was based on the observed/expected lung area to head circumference ratio (O/E LHR), liver herniation, and stomach herniation (AUC, 0.830). The postnatal mortality prediction model was based on O/E LHR, liver herniation, and the lowest oxygenation index (AUC, 0.944).
Conclusion: Our models can facilitate the prenatal and postnatal mortality prediction of infants with isolated left-sided CDH.
(© 2022 Wiley Periodicals LLC.)
Databáze: MEDLINE
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