Suzan C M Cochius-den Otter1,2, Özge Erdem3,2, Joost van Rosmalen4, Thomas Schaible5, Nina C J Peters6, Titia E Cohen-Overbeek6, Irma Capolupo7, Carolin J Falk5, Arno F J van Heijst8, Regina Schäffelder5, Mary E Brindle9, Dick Tibboel3. 1. Intensive Care and Departments of Pediatric Surgery, s.denotter@erasmusmc.nl. 2. Contributed equally as co-first authors. 3. Intensive Care and Departments of Pediatric Surgery. 4. Biostatistics, and. 5. Department of Neonatology, Universitätsmedizin Mannheim, Mannheim, Germany. 6. Obstetrics and Fetal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands. 7. Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital, Rome, Italy. 8. Division of Neonatology, Department of Pediatrics, Radboud University Medical Center Amalia Children's Hospital, Nijmegen, Netherlands; and. 9. Department of Surgery and Community Health Sciences, University of Calgary and Alberta Children's Hospital, Calgary, Canada.
Abstract
BACKGROUND: Congenital diaphragmatic hernia (CDH) is a rare congenital anomaly with a mortality of ∼27%. The Congenital Diaphragmatic Hernia Study Group (CDHSG) developed a simple postnatal clinical prediction rule to predict mortality in newborns with CDH. Our aim for this study is to externally validate the CDHSG rule in the European population and to improve its prediction of mortality by adding prenatal variables. METHODS: We performed a European multicenter retrospective cohort study and included all newborns diagnosed with unilateral CDH who were born between 2008 and 2015. Newborns born from November 2011 onward were included for the external validation of the rule (n = 343). To improve the prediction rule, we included all patients born between 2008 and 2015 (n = 620) with prenatally diagnosed CDH and collected pre- and postnatal variables. We build a logistic regression model and performed bootstrap resampling and computed calibration plots. RESULTS: With our validation data set, the CDHSG rule had an area under the curve of 79.0%, revealing a fair predictive performance. For the new prediction rule, prenatal herniation of the liver was added, and absent 5-minute Apgar score was taken out. The new prediction rule revealed good calibration, and with an area under the curve of 84.6%, it had good discriminative abilities. CONCLUSIONS: In this study, we externally validated the CDHSG rule for the European population, which revealed fair predictive performance. The modified rule, with prenatal liver herniation as an additional variable, appears to further improve the model's ability to predict mortality in a population of patients with prenatally diagnosed CDH.
BACKGROUND:Congenital diaphragmatic hernia (CDH) is a rare congenital anomaly with a mortality of ∼27%. The Congenital Diaphragmatic Hernia Study Group (CDHSG) developed a simple postnatal clinical prediction rule to predict mortality in newborns with CDH. Our aim for this study is to externally validate the CDHSG rule in the European population and to improve its prediction of mortality by adding prenatal variables. METHODS: We performed a European multicenter retrospective cohort study and included all newborns diagnosed with unilateral CDH who were born between 2008 and 2015. Newborns born from November 2011 onward were included for the external validation of the rule (n = 343). To improve the prediction rule, we included all patients born between 2008 and 2015 (n = 620) with prenatally diagnosed CDH and collected pre- and postnatal variables. We build a logistic regression model and performed bootstrap resampling and computed calibration plots. RESULTS: With our validation data set, the CDHSG rule had an area under the curve of 79.0%, revealing a fair predictive performance. For the new prediction rule, prenatal herniation of the liver was added, and absent 5-minute Apgar score was taken out. The new prediction rule revealed good calibration, and with an area under the curve of 84.6%, it had good discriminative abilities. CONCLUSIONS: In this study, we externally validated the CDHSG rule for the European population, which revealed fair predictive performance. The modified rule, with prenatal liver herniation as an additional variable, appears to further improve the model's ability to predict mortality in a population of patients with prenatally diagnosed CDH.
Authors: Philip L J DeKoninck; Emily J J Horn-Oudshoorn; Ronny Knol; Kelly J Crossley; Irwin K M Reiss Journal: Front Pediatr Date: 2021-12-14 Impact factor: 3.418
Authors: Erwin Brosens; Nina C J Peters; Kim S van Weelden; Charlotte Bendixen; Rutger W W Brouwer; Frank Sleutels; Hennie T Bruggenwirth; Wilfred F J van Ijcken; Danielle C M Veenma; Suzan C M Cochius-Den Otter; Rene M H Wijnen; Alex J Eggink; Marieke F van Dooren; Heiko Martin Reutter; Robbert J Rottier; J Marco Schnater; Dick Tibboel; Annelies de Klein Journal: Front Pediatr Date: 2022-02-03 Impact factor: 3.418
Authors: Katinka Weller; Nina C J Peters; Joost van Rosmalen; Suzan C M Cochius-Den Otter; Philip L J DeKoninck; Rene M H Wijnen; Titia E Cohen-Overbeek; Alex J Eggink Journal: Prenat Diagn Date: 2021-07-28 Impact factor: 3.242