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A statistical model to predict nonsurvival in congenital diaphragmatic hernia
Shelley Cypher Springer1, Dawn Fleming, Thomas C Hulsey
1Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
Objective:
To develop a predictive model using echocardiographic indices to identify nonsurvivors from survivors in preoperative patients with congenital diaphragmatic hernia (CDH).
Study Design:
Eight cases of CDH, with a mortality rate of 38%, underwent echocardiographic study before surgical repair. Left ventricular mass (LVMASS) using the area-length method of Wyatt et al. and fractional shortening (FS) by M-mode measurements were determined.
Results:
We identified a nonlinear nonoverlapping distribution that predicted nonsurvivors from survivors, p=0.04. Multiple regression analysis demonstrated the quantity (LVMASS x FS)(1/2) to be correlated with nonsurvival with a coefficient of determination r(2)=0.55. Comparison of the means of the quantity (LVMASS x FS)(1/2) for the two groups suggested two distinct populations, p=0.04.
Conclusion:
The mathematical quantity (LVMASS x FS)(1/2) calculated from echocardiographic measurements obtained preoperatively in babies with CDH may predict nonsurvival despite maximal intervention.