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