A statistical model to predict nonsurvival in congenital diaphragmatic hernia.
OBJECTIVE
To develop a predictive model using echocardiographic indices to identify nonsurvivors from survivors in preoperative patients with congenital diaphragmatic hernia (CDH).


METHODS
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.


CONCLUSIONS
The mathematical quantity (LVMASS x FS)(1/2) calculated from echocardiographic measurements obtained preoperatively in babies with CDH may predict nonsurvival despite maximal intervention.
Springer
Shelley Cypher
SC
Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
Fleming
Dawn
D
Hulsey
Thomas C
TC
D005260:Female; D006548:Hernia, Diaphragmatic / Q000000981:diagnostic imaging / Q000401:mortality*; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D015233:Models, Statistical; D011237:Predictive Value of Tests; D014463:Ultrasonography