Pediatr Surg Int

. 2022 Nov 28;39(1):4.

 doi: 10.1007/s00383-022-05287-9. https://pubmed.ncbi.nlm.nih.gov/36441244/

A predictive scoring system for small diaphragmatic defects in infants with congenital diaphragmatic hernia

Keita Terui ¹, Kouji Nagata ², Masaya Yamoto ³, Masahiro Hayakawa ⁴, Hiroomi Okuyama ⁵, Shoichiro Amari ⁶, Akiko Yokoi ⁷, Taizo Furukawa ⁸, Kouji Masumoto ⁹, Tadaharu Okazaki ¹⁰, Noboru Inamura ¹¹, Katsuaki Toyoshima ¹², Yuhki Koike ¹³, Manabu Okawada ¹⁴, Yasunori Sato ¹⁵, Noriaki Usui ¹⁶

Affiliations expand

• PMID: 36441244
• DOI: 10.1007/s00383-022-05287-9

Abstract

Purpose: To develop a predictive score for small diaphragmatic defects in infants with congenital diaphragmatic hernia (CDH) for determining thoracoscopic surgery indication.

Methods: The Japanese CDH Study Group cohort was randomly divided into derivation (n = 397) and validation (n = 396) datasets. Using logistic regression, a prediction model and weighted scoring system for small diaphragmatic defects were created from derivation dataset and validated with validation dataset.

Results: Six weighted variables were selected: no hydramnios, 1 point; 1 min Apgar score of 5-10, 1 point; apex type of the lung (left lung is detected radiographically in apex area), 1 point; oxygenation index < 8, 1 point; abdominal nasogastric tube (tip of the nasogastric tube is detected radiographically in the abdominal area), 2 points; no right-to-left flow of ductus arteriosus, 1 point. In validation dataset, rates of small diaphragmatic defects for Possible (0-3 points), Probable (4-5 points), and Definite (6-7 points) groups were 36%, 81%, and 94%, respectively (p < 0.001). Additionally, sensitivity, specificity, positive predictive value, and C statistics were 0.78, 0.79, 0.88, 0.76, and 0.45, 0.94, 0.94, 0.70 for Probable and Definite groups, respectively.

Conclusion: Our scoring system effectively predicted small diaphragmatic defects in infants with CDH.

Keywords: Congenital abnormalities; Congenital diaphragmatic hernia; Diaphragm; Minimally invasive surgical procedures; Statistical models.

© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature