Predicting the risk of infant mortality for newborns operated for congenital heart defects: A population‐based cohort (EPICARD) study of two post‐operative predictive scores
Abstract Background Whereas no global severity score exists for congenital heart defects (CHD), risk (Risk Adjusted Cardiac Heart Surgery‐1: RACHS‐1) and/or complexity (Aristotle Basic Complexity: ABC) scores have been developed for those who undergo surgery. Population‐based studies for assessing t...
Main Authors: | , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Wiley
2021-06-01
|
Series: | Health Science Reports |
Subjects: | |
Online Access: | https://doi.org/10.1002/hsr2.300 |
id |
doaj-abe2b3cbb9a54deaa7396a8f3711b1bc |
---|---|
record_format |
Article |
spelling |
doaj-abe2b3cbb9a54deaa7396a8f3711b1bc2021-06-28T17:45:42ZengWileyHealth Science Reports2398-88352021-06-0142n/an/a10.1002/hsr2.300Predicting the risk of infant mortality for newborns operated for congenital heart defects: A population‐based cohort (EPICARD) study of two post‐operative predictive scoresNathalie Lelong0Karim Tararbit1Lise‐Marie Le Page‐Geniller2Jérémie Cohen3Souad Kout4Laurence Foix‐L'Hélias5Pascal Boileau6Martin Chalumeau7François Goffinet8Babak Khoshnood9the EPICARD Study GroupINSERM Obstetrical, Perinatal and Pediatric Epidemiology Research Team Université de Paris, CRESS Paris FranceINSERM Obstetrical, Perinatal and Pediatric Epidemiology Research Team Université de Paris, CRESS Paris FranceINSERM Obstetrical, Perinatal and Pediatric Epidemiology Research Team Université de Paris, CRESS Paris FranceINSERM Obstetrical, Perinatal and Pediatric Epidemiology Research Team Université de Paris, CRESS Paris FranceDepartment of Neonatology CHI André Grégoire Montreuil FranceINSERM Obstetrical, Perinatal and Pediatric Epidemiology Research Team Université de Paris, CRESS Paris FranceDepartment of Neonatology CHI Poissy Saint‐Germain‐en‐Laye Poissy FranceINSERM Obstetrical, Perinatal and Pediatric Epidemiology Research Team Université de Paris, CRESS Paris FranceINSERM Obstetrical, Perinatal and Pediatric Epidemiology Research Team Université de Paris, CRESS Paris FranceINSERM Obstetrical, Perinatal and Pediatric Epidemiology Research Team Université de Paris, CRESS Paris FranceAbstract Background Whereas no global severity score exists for congenital heart defects (CHD), risk (Risk Adjusted Cardiac Heart Surgery‐1: RACHS‐1) and/or complexity (Aristotle Basic Complexity: ABC) scores have been developed for those who undergo surgery. Population‐based studies for assessing the predictive ability of these scores are lacking. Objective To assess the predictive ability of RACHS‐1 and ABC scores for the risk of infant mortality using population‐based cohort (EPICARD) data for newborns with structural CHD. Methods The study population comprised 443 newborns who underwent curative surgery. We assessed the predictive ability of each score alone and in conjunction with an a priori selected set of predictors of infant mortality. Statistical analysis included logistic regression models for which we computed model calibration, discrimination (ROC), and a rarely used but clinically meaningful measure of variance explained (Tjur's coefficient of discrimination). Results The risk of mortality increased with increasing RACHS‐1 and the ABC scores and models based on both scores had adequate calibration. Model discrimination was higher for the RACHS‐1‐based model (ROC 0.68, 95% CI, 0.58‐0.79) than the ABC‐based one (ROC 0.59, 95% CI, 0.49‐0.69), P = 0.03. Neither score had the good predictive ability when this was assessed using Tjur's coefficient. Conclusions Even if the RACHS‐1 score had better predictive ability, both scores had low predictive ability using a variance‐explained measure. Because of this limitation and the fact that neither score can be used for newborns with CHD who do not undergo surgery, it is important to develop new predictive models that comprise all newborns with structural CHD.https://doi.org/10.1002/hsr2.300congenital heart defectsinfant mortalityseverity scoresthoracic surgery |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Nathalie Lelong Karim Tararbit Lise‐Marie Le Page‐Geniller Jérémie Cohen Souad Kout Laurence Foix‐L'Hélias Pascal Boileau Martin Chalumeau François Goffinet Babak Khoshnood the EPICARD Study Group |
spellingShingle |
Nathalie Lelong Karim Tararbit Lise‐Marie Le Page‐Geniller Jérémie Cohen Souad Kout Laurence Foix‐L'Hélias Pascal Boileau Martin Chalumeau François Goffinet Babak Khoshnood the EPICARD Study Group Predicting the risk of infant mortality for newborns operated for congenital heart defects: A population‐based cohort (EPICARD) study of two post‐operative predictive scores Health Science Reports congenital heart defects infant mortality severity scores thoracic surgery |
author_facet |
Nathalie Lelong Karim Tararbit Lise‐Marie Le Page‐Geniller Jérémie Cohen Souad Kout Laurence Foix‐L'Hélias Pascal Boileau Martin Chalumeau François Goffinet Babak Khoshnood the EPICARD Study Group |
author_sort |
Nathalie Lelong |
title |
Predicting the risk of infant mortality for newborns operated for congenital heart defects: A population‐based cohort (EPICARD) study of two post‐operative predictive scores |
title_short |
Predicting the risk of infant mortality for newborns operated for congenital heart defects: A population‐based cohort (EPICARD) study of two post‐operative predictive scores |
title_full |
Predicting the risk of infant mortality for newborns operated for congenital heart defects: A population‐based cohort (EPICARD) study of two post‐operative predictive scores |
title_fullStr |
Predicting the risk of infant mortality for newborns operated for congenital heart defects: A population‐based cohort (EPICARD) study of two post‐operative predictive scores |
title_full_unstemmed |
Predicting the risk of infant mortality for newborns operated for congenital heart defects: A population‐based cohort (EPICARD) study of two post‐operative predictive scores |
title_sort |
predicting the risk of infant mortality for newborns operated for congenital heart defects: a population‐based cohort (epicard) study of two post‐operative predictive scores |
publisher |
Wiley |
series |
Health Science Reports |
issn |
2398-8835 |
publishDate |
2021-06-01 |
description |
Abstract Background Whereas no global severity score exists for congenital heart defects (CHD), risk (Risk Adjusted Cardiac Heart Surgery‐1: RACHS‐1) and/or complexity (Aristotle Basic Complexity: ABC) scores have been developed for those who undergo surgery. Population‐based studies for assessing the predictive ability of these scores are lacking. Objective To assess the predictive ability of RACHS‐1 and ABC scores for the risk of infant mortality using population‐based cohort (EPICARD) data for newborns with structural CHD. Methods The study population comprised 443 newborns who underwent curative surgery. We assessed the predictive ability of each score alone and in conjunction with an a priori selected set of predictors of infant mortality. Statistical analysis included logistic regression models for which we computed model calibration, discrimination (ROC), and a rarely used but clinically meaningful measure of variance explained (Tjur's coefficient of discrimination). Results The risk of mortality increased with increasing RACHS‐1 and the ABC scores and models based on both scores had adequate calibration. Model discrimination was higher for the RACHS‐1‐based model (ROC 0.68, 95% CI, 0.58‐0.79) than the ABC‐based one (ROC 0.59, 95% CI, 0.49‐0.69), P = 0.03. Neither score had the good predictive ability when this was assessed using Tjur's coefficient. Conclusions Even if the RACHS‐1 score had better predictive ability, both scores had low predictive ability using a variance‐explained measure. Because of this limitation and the fact that neither score can be used for newborns with CHD who do not undergo surgery, it is important to develop new predictive models that comprise all newborns with structural CHD. |
topic |
congenital heart defects infant mortality severity scores thoracic surgery |
url |
https://doi.org/10.1002/hsr2.300 |
work_keys_str_mv |
AT nathalielelong predictingtheriskofinfantmortalityfornewbornsoperatedforcongenitalheartdefectsapopulationbasedcohortepicardstudyoftwopostoperativepredictivescores AT karimtararbit predictingtheriskofinfantmortalityfornewbornsoperatedforcongenitalheartdefectsapopulationbasedcohortepicardstudyoftwopostoperativepredictivescores AT lisemarielepagegeniller predictingtheriskofinfantmortalityfornewbornsoperatedforcongenitalheartdefectsapopulationbasedcohortepicardstudyoftwopostoperativepredictivescores AT jeremiecohen predictingtheriskofinfantmortalityfornewbornsoperatedforcongenitalheartdefectsapopulationbasedcohortepicardstudyoftwopostoperativepredictivescores AT souadkout predictingtheriskofinfantmortalityfornewbornsoperatedforcongenitalheartdefectsapopulationbasedcohortepicardstudyoftwopostoperativepredictivescores AT laurencefoixlhelias predictingtheriskofinfantmortalityfornewbornsoperatedforcongenitalheartdefectsapopulationbasedcohortepicardstudyoftwopostoperativepredictivescores AT pascalboileau predictingtheriskofinfantmortalityfornewbornsoperatedforcongenitalheartdefectsapopulationbasedcohortepicardstudyoftwopostoperativepredictivescores AT martinchalumeau predictingtheriskofinfantmortalityfornewbornsoperatedforcongenitalheartdefectsapopulationbasedcohortepicardstudyoftwopostoperativepredictivescores AT francoisgoffinet predictingtheriskofinfantmortalityfornewbornsoperatedforcongenitalheartdefectsapopulationbasedcohortepicardstudyoftwopostoperativepredictivescores AT babakkhoshnood predictingtheriskofinfantmortalityfornewbornsoperatedforcongenitalheartdefectsapopulationbasedcohortepicardstudyoftwopostoperativepredictivescores AT theepicardstudygroup predictingtheriskofinfantmortalityfornewbornsoperatedforcongenitalheartdefectsapopulationbasedcohortepicardstudyoftwopostoperativepredictivescores |
_version_ |
1721356345371787264 |