Development of mortality prediction models for infants with isolated,left‐sided congenital diaphragmatic hernia before and after birth
Development of mortality prediction models for infants with isolated,left‐sided congenital diaphragmatic hernia before and after birth
复制标题
孤立性左侧先天性膈疝婴儿出生前后死亡率预测模型的开发
DOI：
10.1002/ppul.26172
复制
发表时间：
2023
影响因子：
3.1
通讯作者：
Usui Noriaki
中科院分区：
文献类型：
--
作者：
Yoneda Kota;Amari Shoichiro;Mikami Masashi;Uchida Keiichi;Yokoi Akiko;Okawada Manabu;Furukawa Taizo;Toyoshima Katsuaki;Inamura Noboru;Okazaki Tadaharu;Yamoto Masaya;Masumoto Kouji;Terui Keita;Okuyama Hiroomi;Hayakawa Masahiro;Taguchi Tomoaki;Usui Noriaki
背景先天性腹股沟疝（CDH）的死亡率预测对于制定治疗策略（包括胎儿治疗）至关重要。一些研究人员报道了这种罕见但危及生命的疾病的预后因素;但是，在此情况下，ObjectiveThis study aims to develop the most discriminative prednatal and postnatal models to predict mortality of infants with an isolated left sided CDH.MethodsThis multi-institutional retrospective cohort study included infants with CDH born at 15 tire hospitals of Japanese CDH Study.集团于2011年至2016年。我们开发了多变量logistic模型，每一个可能的组合的预测和识别模型的最高交叉验证面积下的接收器工作特征曲线（AUC）的产前和产后predictions.ResultsAmong 302个合格的婴儿，44出院前死亡。产前死亡率预测模型基于观察到的/预期的肺面积与头围比（O/E LHR）、肝疝和胃疝（AUC，0.830）。出生后死亡率预测模型基于O/E LHR、肝疝和最低氧合指数（AUC，0.944）。结论我们的模型可以促进孤立性左侧CDH婴儿的产前和出生后死亡率预测。
BackgroundMortality 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.ObjectivesThis study aimed to develop the most discriminative prenatal and postnatal models to predict the mortality of infants with an isolated left‐sided CDH.MethodsThis 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.ResultsAmong 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).ConclusionOur models can facilitate the prenatal and postnatal mortality prediction of infants with isolated left‐sided CDH.