Zhou Yating,Yi Min,Qiu Hongxiang,et al.Establishing a nomogram model for predicting postoperative mortality risk in children with complex congenital heart disease[J].Journal of Clinical Pediatric Surgery,,22():48-55.[doi:10.3760/cma.j.cn101785-202201026-010]
Establishing a nomogram model for predicting postoperative mortality risk in children with complex congenital heart disease
- Keywords:
- Infant; Newborn; Heart Diseases; Mortality; Nomograms; Statistics
- Abstract:
- ObjectiveTo construct a nomogram model for predicting the mortality risk of postoperative in children with complex congenital heart disease (CCHD) and validate its predictive potence.MethodsFrom January 2018 to December 2019,a retrospective review was conducted for 354 CCHD children undergoing cardiopulmonary bypass (CPB) thoracotomy.And independent risk factors for postoperative mortality were screened by univariate and multivariate Logistic regression analyses and constructing a nomogram prediction model.ResultsThe independent postoperative mortality risk factors for CCHD children were as follows:inotropic score increased(IS,OR=1.113,95%CI:1.055-1.175),white blood cell increased(WBC,OR=1.140,95%CI:1.044-1.245),hemoglobin decreased(HB,OR=0.973,95%CI:0.949-0.998),albumin decreased(ALB,OR=0.907,95%CI:0.838-0.983) and cardiopulmonary resuscitation-preoperative (CPR-pre,OR=36.656,95%CI:5.187-259.037).A nomogram prediction model was constructed with the above risk factors as input variables and output variable was total score.The higher total scores,the greater of mortality and vice versa.This model verification showed that C-index and area under curve (AUC) were 0.898 and 0.899 respectively.And calibration curve was close to ideal,indicating decent prediction and discriminant validity.Also the optimal cut-off value was 36.ConclusionIS,WBC,HB,ALB and CPR-pre are independent postoperative mortality risk factors for CCHD children.The nomogram model constructed on the basis of five risk factors offers excellent predictive accuracy.Individuals with a total score ≥36 should raise a high alert and more aggressive intervention is required for a better prognosis.
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Memo
收稿日期:2022-01-12。
基金项目:重庆市科卫联合医学科研项目(2019MSXM006)
通讯作者:易敏,Email:744173239@qq.com