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三种不同的多器官功能障碍评分对预测新生儿心脏手术后死亡率的比较。

Comparison of Three Different Multiple Organ Dysfunction Scores for Predicting Mortality after Neonatal Cardiac Surgery.

作者信息

Bezirganoglu Handan, Okur Nilufer, Ozdemir Fatih, Gul Ozlem, Aldudak Bedri

机构信息

Division of Neonatology, Trabzon Kanuni Training and Research Hospital, Trabzon 61250, Türkiye.

Division of Neonatology, Diyarbakir Gazi Yasargil Training and Research Hospital, Diyarbakir 21010, Türkiye.

出版信息

Children (Basel). 2023 Aug 1;10(8):1333. doi: 10.3390/children10081333.

DOI:10.3390/children10081333
PMID:37628332
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10453477/
Abstract

Infants who undergo cardiac surgery frequently have complications that may advance to multiple organ failure and result in mortality. This study aims to compare three different multiple organ dysfunction scoring systems: the Neonatal Multiple Organ Dysfunction (NEOMOD) score, the modified NEOMOD score, and the Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score in predicting postoperative 30-day mortality in neonates undergoing cardiac surgery. This retrospective cohort study was conducted between January 2019 and February 2021 in a single unit on neonates operated on due to congenital heart disease in the first 28 days of life. Patients who underwent off-pump surgeries were excluded from the study. The NEOMOD, modified NEOMOD, and PELOD-2 scores were calculated for each of the first 3 days following surgery. A total of 138 patients were included. All scores had satisfactory goodness-of-fit and at least good discriminative ability on each day. The modified NEOMOD score consistently demonstrated the best prediction among these three scores after the first day, reaching its peak performance on day 2 (area under curve: 0.824, CI: 0.75-0.89). Our findings suggest that NEOMOD and modified NEOMOD scores in the first 72 h could potentially serve as a predictor of mortality in this population.

摘要

接受心脏手术的婴儿经常出现并发症,这些并发症可能发展为多器官功能衰竭并导致死亡。本研究旨在比较三种不同的多器官功能障碍评分系统:新生儿多器官功能障碍(NEOMOD)评分、改良NEOMOD评分和小儿逻辑器官功能障碍-2(PELOD-2)评分,以预测接受心脏手术的新生儿术后30天死亡率。这项回顾性队列研究于2019年1月至2021年2月在一个单位对出生后28天内因先天性心脏病接受手术的新生儿进行。接受非体外循环手术的患者被排除在研究之外。在术后的前3天每天计算NEOMOD、改良NEOMOD和PELOD-2评分。共纳入138例患者。所有评分在每一天都具有良好的拟合优度和至少良好的判别能力。改良NEOMOD评分在第一天后始终在这三个评分中表现出最佳预测能力,在第2天达到最佳性能(曲线下面积:0.824,CI:0.75-0.89)。我们的研究结果表明,前72小时的NEOMOD和改良NEOMOD评分可能作为该人群死亡率的预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7b0/10453477/5c895c30f413/children-10-01333-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7b0/10453477/d93c3dc24384/children-10-01333-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7b0/10453477/5707fd097135/children-10-01333-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7b0/10453477/5c895c30f413/children-10-01333-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7b0/10453477/d93c3dc24384/children-10-01333-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7b0/10453477/5707fd097135/children-10-01333-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7b0/10453477/5c895c30f413/children-10-01333-g003.jpg

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Diagnostics (Basel). 2021 Oct 21;11(11):1955. doi: 10.3390/diagnostics11111955.
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