Accuracy of cardiac auscultation in detection of neonatal congenital heart disease by general paediatricians
| Autor: | Xiao-jing Ma, Fang Liu, Lin Wu, Guoying Huang, Conway Niu, Qu-Ming Zhao |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Heart Defects
Congenital Male China Pediatrics medicine.medical_specialty Heart disease 030204 cardiovascular system & hematology Cardiac auscultation Sensitivity and Specificity Asymptomatic 03 medical and health sciences Neonatal Screening 0302 clinical medicine 030225 pediatrics medicine False positive paradox Humans False Positive Reactions Oximetry Pediatricians Prospective Studies cardiovascular diseases Prospective cohort study Newborn screening Heart Murmurs medicine.diagnostic_test business.industry Infant Newborn General Medicine Auscultation medicine.disease ROC Curve Pediatrics Perinatology and Child Health Female False positive rate medicine.symptom Cardiology and Cardiovascular Medicine business Heart Auscultation |
| Zdroj: | Cardiology in the Young. 29:679-683 |
| ISSN: | 1467-1107 1047-9511 |
| DOI: | 10.1017/s1047951119000799 |
| Popis: | Background:Challenges remain in the judgement of pathological murmurs in newborns at maternity hospitals, and there are still many simple major CHD patients in developing countries who are not diagnosed in a timely fashion. This study aimed to evaluate the accuracy of cardiac auscultation on neonatal CHD by general paediatricians.Methods:We conducted a prospective study at three hospitals. All asymptomatic newborns underwent auscultation, pulse oximetry monitoring, and echocardiography. Major CHD was classified and confirmed through follow-up. We evaluated the accuracy of various degrees of murmurs for detecting major CHD to determine the most appropriate standards and time of auscultation.Results:A total of 6750 newborns were included. The median age of auscultation was 43 hours. Cardiac murmurs were identified in 6.6% of newborns. For all CHD, 44.4% had varying degrees of murmurs. A murmur of grade ≥2 used as a reference standard for major CHD had a sensitivity of 89.58%. The false positive rate of murmurs of grade ≥2 for detecting major CHD was significantly negatively related to auscultation time, with 84.4% of false positives requiring follow-up for non-major CHD cardiac issues. Auscultation after 27 hours of life could reduce the false positive rate of major CHD from 2.7 to 0.9%.Conclusions:With appropriate training, maternity hospital’s paediatricians can detect major CHD with high detection rates with an acceptable false positive rate. |
| Databáze: | OpenAIRE |
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