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01.12.2023 | Original Article

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

verfasst von: Keita Terui, Kouji Nagata, Masaya Yamoto, Masahiro Hayakawa, Hiroomi Okuyama, Shoichiro Amari, Akiko Yokoi, Taizo Furukawa, Kouji Masumoto, Tadaharu Okazaki, Noboru Inamura, Katsuaki Toyoshima, Yuhki Koike, Manabu Okawada, Yasunori Sato, Noriaki Usui

Erschienen in: Pediatric Surgery International | Ausgabe 1/2023

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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.

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Titel: A predictive scoring system for small diaphragmatic defects in infants with congenital diaphragmatic hernia
verfasst von: Keita Terui
Kouji Nagata
Masaya Yamoto
Masahiro Hayakawa
Hiroomi Okuyama
Shoichiro Amari
Akiko Yokoi
Taizo Furukawa
Kouji Masumoto
Tadaharu Okazaki
Noboru Inamura
Katsuaki Toyoshima
Yuhki Koike
Manabu Okawada
Yasunori Sato
Noriaki Usui
Publikationsdatum: 01.12.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 1/2023
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-022-05287-9

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