Extracorporeal Membrane Oxygenation (ECMO) Risk Stratification in Newborns with Congenital Diaphragmatic Hernia (CDH)

Journal of Pediatric Surgery
Tim JancelewiczCongenital Diaphragmatic Hernia Study Group

Abstract

A means for early postnatal stratification of ECMO risk in CDH newborns could be used to comparatively assess the utilization and outcomes of ECMO use between centers. While multiple CDH mortality risk calculators are available, no validated tool exists specifically for prediction of ECMO use. The purpose of this study was to derive and validate an ECMO risk stratification model. The study population was obtained from CDH Study Group registry for the period between 2007 and 2016. Only centers offering ECMO were included. The cohort was restricted to ECMO candidates and then divided into derivation and validation sets. Using all relevant perinatal predictors in the registry, univariate analysis was performed for the composite outcome of ECMO use or death without ECMO use. The model was derived using the derivation cohort with multivariable logistic regression and automatic stepwise forward selection (P < 0.05 for qualifying variables), and a c-statistic was obtained. The model was then tested on the validation cohort. Sample reuse validation and bootstrap validation were performed. The validated model was then tested for accuracy on CDH subgroups. There were 1992 patients in the derivation cohort. Four significant variables were...Continue Reading

Citations

Aug 15, 2019·American Journal of Respiratory and Critical Care Medicine·Neil PatelMatthew T Harting
Dec 1, 2020·Pediatric Radiology·Amy R Mehollin-Ray
Nov 5, 2019·Journal of Pediatric Surgery·David K LeopoldSteven L Moulton
Nov 3, 2021·European Journal of Pediatrics·Rameshwar PrasadAmit Kumar

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