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

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

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

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.

Original languageEnglish
Article number4
JournalPediatric surgery international
Volume39
Issue number1
DOIs
Publication statusPublished - 2023 Dec

Keywords

  • Congenital abnormalities
  • Congenital diaphragmatic hernia
  • Diaphragm
  • Minimally invasive surgical procedures
  • Statistical models

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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