Magnetic Resonance-Based Diagnostics for Bleeding Assessment in Neonatal Cardiac Surgery
| Autor: | Joseph E. Marturano, Perry S. Choi, Sitaram M. Emani, Sirisha Emani, Juan C. Ibla, Thomas Jay Lowery |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Pulmonary and Respiratory Medicine
Heart Defects Congenital Male medicine.medical_specialty Platelet Function Tests Population Magnetic Resonance Imaging Cine Recursive partitioning 030204 cardiovascular system & hematology Postoperative Hemorrhage 03 medical and health sciences 0302 clinical medicine Interquartile range Predictive Value of Tests medicine Humans Prospective Studies Cardiac Surgical Procedures education Prospective cohort study education.field_of_study medicine.diagnostic_test Receiver operating characteristic business.industry Infant Newborn Infant Magnetic resonance imaging Cardiac surgery 030228 respiratory system ROC Curve Predictive value of tests Surgery Female Radiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Annals of thoracic surgery. 109(6) |
| ISSN: | 1552-6259 |
| Popis: | Purpose Infants undergoing a cardiac operation are at high risk for postsurgical bleeding. To date, there are no highly predictive models for postsurgical bleeding in this population. This study's objective was to assess the predictive ability of T2 magnetic resonance (T2MR). Description T2MR uses magnetic resonance to detect clot formation characteristics on a small blood sample and provides hemostatic indicators that can assess bleeding risk. Evaluation This prospective, single-institution study enrolled 100 patients younger than 12 months old undergoing a cardiac operation from April 27, 2015, to September 21, 2016. The primary end point was postsurgical bleeding within 24 hours after the procedure. T2MR data were modeled with a binary recursive partitioning algorithm with randomized cross-validation. The tight clot metric produced the highest univariate discrimination of bleeding (receiver operator characteristic curve, 0.64; classification accuracy, 72%), and along with the platelet function metric, demonstrated highest relative importance based on Gini index splitting (Salford Systems, San Diego, CA). Multivariate modeling with cross-validation showed mean receiver operator characteristic curve area of 0.74 and classification accuracy of 82%. Conclusions T2MR tight clot and platelet function metrics were associated with bleeding events. |
| Databáze: | OpenAIRE |
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