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Updated: Aug 20, 2025
Transuterine Fetal Tracheal Occlusion Model in Mice
Published on: February 5, 2021
Development and internal validation of a prediction model to predict survival for congenital diaphragmatic hernia in
Weihua Pan1, Weipeng Wang1, Wenjie Wu1
1Department of Pediatric Surgery, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
A new model predicts survival for infants with congenital diaphragmatic hernia (CDH) using easily available early data. This tool aids in early postnatal risk assessment for CDH patients.
Area of Science:
- Neonatalogy
- Pediatric Surgery
- Medical Informatics
Background:
- Congenital diaphragmatic hernia (CDH) is a serious condition requiring accurate early prognostication.
- Existing predictive models for CDH survival may lack generalizability or ease of application.
- The Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD) guideline promotes robust model development.
Purpose of the Study:
- To develop a simple, generalizable, and easily applied predictive model for early postnatal survival in infants with congenital diaphragmatic hernia (CDH).
- To adhere to the TRIPOD guideline for transparent reporting of the prediction model.
Main Methods:
- A retrospective study included 225 neonates diagnosed with CDH between 2001 and 2018, excluding those who received fetal endoscopic tracheal occlusion or ECMO.
- Key variables readily available within the first hour of admission were identified: birth weight, 1-min Apgar score, hernia side, liver herniation, and admission PaCO2.
- A multivariable logistic regression model was constructed and its predictive performance was evaluated.
Main Results:
- The developed model, using five clinical variables, achieved an area under the receiver operating characteristic curve (AUC) of 0.912, outperforming single biomarkers.
- The model demonstrated high sensitivity (90.6%) and specificity (74.6%) for predicting CDH survival.
- Good calibration was observed (Hosmer-Lemeshow p=0.410), with superior discriminative ability compared to previous CDH predictive models.
Conclusions:
- A simple and generalizable five-predictor model for early CDH prognosis was successfully developed following TRIPOD guidelines.
- The model exhibits strong performance in predicting survival rates for infants with CDH.
- This predictive tool holds significant promise for future clinical application in managing CDH.
Purpose:
To develop an easily applied predictive model to predict survival rate for infants with congenital diaphragmatic hernia (CDH) in the early postnatal period according to the Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD) guideline.
Methods:
The retrospective study was conducted including 225 neonates with prenatal or postnatal diagnosed CDH between 2001 and 2018. Patients did not receive the therapy of fetal endoscopic tracheal occlusion and extracorporeal membrane oxygenation. The study took into consideration these variables that are easily available in most centers within the first 1 h after admission. A multivariable prediction model to predict the survival rate for CDH was generated and its performance was analyzed.
Results:
The multiple logistic regression analysis was generated using five clinical variables that are routinely available in most centers, including birth weight, 1-min Apgar score, side of hernia, presence of liver herniation, and PaCO2 in the admission arterial blood analysis. The area under the receiver operating characteristic curve value for this model was 0.912, which was greater than that of a single biomarker in predicting the survival rate of CDH. This model had a sensitivity of 90.6% and a specificity of 74.6%. This model demonstrated good calibration (Hosmer-Lemeshow goodness-of-fit test, p = .410). Besides, the model had a better discriminative ability compared to the previously established predictive models of CDH.
Conclusions:
The simple and generalizable model was developed by five predictors for CDH in the early period using the TRIPOD checklist. It demonstrated good performance in predicting the survival rate of infants with CDH, holding promise for future clinical application.
