عنوان

Development and Validation of ECMO Mortality-Risk Models for Congenital Diaphragmatic Hernia

شماره

TL5286550g

زبان متن نوشتاري يا گفتاري و مانند آن

انگلیسی

عنوان اصلي

Development and Validation of ECMO Mortality-Risk Models for Congenital Diaphragmatic Hernia

نام عام مواد

[Thesis]

نام نخستين پديدآور

Guner, Yigit S.

نام ساير پديدآوران

Cleary, JohnYu, Peter

تاریخ نشرو بخش و غیره

2017

کسي که مدرک را اعطا کرده

Cleary, JohnYu, Peter

امتياز متن

2017

متن يادداشت

Rationale: There are no validated bedside tools that can predict mortality risk of a neonate with CDH prior to initiation of ECMO and during the course of ECMO. Objectives: To develop ECMO specific mortality risk prediction models for CDH. Methods: The Extracorporeal Life Support Organization (ELSO) registry (2000-2015) was used to develop mortality prediction scores for CDH relative to timing of ECMO. Prediction models were developed using multivariable logistic regression models. Observed mortalities for the pre- and on-ECMO were further examined by five clinical risk groups defined by percentiles of the risk score. Results: We identified 4,374 neonates with CDH with an overall mortality of 52%. Predictive discrimination (C-statistic) for pre-ECMO mortality model was C = 0.65 (95% CI: 0.62-0.68). Within the highest risk group, based on the pre-ECMO risk score, mortality was with 87% (144 neonates) and 75% (92 neonates), in the training and validation datasets, respectively. The pre-ECMO risk score included pre-ECMO ventilator settings, pH, prior DH repair, critical congenital heart disease, perinatal infection, and demographics. For the on-ECMO model, mortality prediction improved substantially: C = 0.73 (95% CI: 0.71-0.76) with the addition of on-ECMO associated complications and comorbidities. Within the highest risk group, defined by the on-ECMO risk score, mortality was 90% (147 neonates) and 86% (77 neonates) in the training and validation datasets, respectively. The post-ECMO mortality prediction model which accounted for the timing of CDH repair post-ECMO had the best predictive discrimination with C = 0.80 (95% CI: 0.78-0.82). Conclusion: Mortality among neonates with CDH needing ECMO can be reliably predicted with validated clinical variables identified in this study relative to timing of ECMO.

مستند نام اشخاص تاييد نشده

Xu, Bin

مستند نام اشخاص تاييد نشده

Guner, Yigit S.

مستند نام تنالگان تاييد نشده

UC Irvine

نام الکترونيکي

فرمت انتشار

p

نوع ماده

[Thesis]

کد کاربرگه

276903

سطح دسترسي

a

تكميل شده

Y