SNAP-II Predicts Mortality among Infants with Congenital Diaphragmatic Hernia
OBJECTIVE: Outcomes analysis in congenital diaphragmatic hernia (CDH) requires a validated risk-adjustment tool. The purpose of this study was to use the Canadian Neonatal Network (CNN) database to validate the Score for Neonatal Acute Physiology, Version II (SNAP-II) for prediction of mortality amo...
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Veröffentlicht in: | Journal of Perinatology 2005-05, Vol.25 (5), p.315-319 |
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creator | Skarsgard, Erik D MacNab, Ying C Qiu, Zhenguo Little, Ruth Lee, Shoo K |
description | OBJECTIVE:
Outcomes analysis in congenital diaphragmatic hernia (CDH) requires a validated risk-adjustment tool. The purpose of this study was to use the Canadian Neonatal Network (CNN) database to validate the Score for Neonatal Acute Physiology, Version II (SNAP-II) for prediction of mortality among CDH infants admitted to a neonatal intensive care unit (NICU), and to compare this to the predictive equation recently developed by the Congenital Diaphragmatic Hernia Study Group (CDHSG).
STUDY DESIGN:
Infants with CDH in the CNN database were identified. Bivariate and multivariable logistic regression models were used to identify risk factors predictive of mortality. Model predictive performance and calibration were assessed using the area under the receiver operator characteristic curve and the technique of Hosmer-Lemeshow, respectively, and compared with the CDHSG predictive equation.
RESULTS:
There were 88 patients with CDH among 19,507 admissions to CNN hospitals. The mortality rate among CDH patients surviving to NICU admission was 17%, and 12.5% received extracorporeal membrane oxygenation therapy. Gestational age and admission SNAP-II score predicted mortality. Model predictive performance and calibration were optimized with these variables combined. The CDHSG equation was equally predictive of mortality, but was only marginally calibrated.
CONCLUSIONS:
SNAP-II is highly predictive of mortality among patients with CDH, and can be used to risk-adjust these patients. |
doi_str_mv | 10.1038/sj.jp.7211257 |
format | Article |
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Outcomes analysis in congenital diaphragmatic hernia (CDH) requires a validated risk-adjustment tool. The purpose of this study was to use the Canadian Neonatal Network (CNN) database to validate the Score for Neonatal Acute Physiology, Version II (SNAP-II) for prediction of mortality among CDH infants admitted to a neonatal intensive care unit (NICU), and to compare this to the predictive equation recently developed by the Congenital Diaphragmatic Hernia Study Group (CDHSG).
STUDY DESIGN:
Infants with CDH in the CNN database were identified. Bivariate and multivariable logistic regression models were used to identify risk factors predictive of mortality. Model predictive performance and calibration were assessed using the area under the receiver operator characteristic curve and the technique of Hosmer-Lemeshow, respectively, and compared with the CDHSG predictive equation.
RESULTS:
There were 88 patients with CDH among 19,507 admissions to CNN hospitals. The mortality rate among CDH patients surviving to NICU admission was 17%, and 12.5% received extracorporeal membrane oxygenation therapy. Gestational age and admission SNAP-II score predicted mortality. Model predictive performance and calibration were optimized with these variables combined. The CDHSG equation was equally predictive of mortality, but was only marginally calibrated.
CONCLUSIONS:
SNAP-II is highly predictive of mortality among patients with CDH, and can be used to risk-adjust these patients.</description><identifier>ISSN: 0743-8346</identifier><identifier>EISSN: 1476-5543</identifier><identifier>DOI: 10.1038/sj.jp.7211257</identifier><identifier>PMID: 15716986</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>Apgar score ; Birth weight ; Bivariate analysis ; Calibration ; Cause of Death ; Cohort Studies ; Critical Care - standards ; Critical Care - trends ; Diaphragm ; Extracorporeal membrane oxygenation ; Female ; Gestational age ; Health Status Indicators ; Hernia ; Hernia, Diaphragmatic - diagnosis ; Hernia, Diaphragmatic - mortality ; Hernias ; Hernias, Diaphragmatic, Congenital ; Humans ; Infant, Newborn ; Infants ; Intensive care ; Intensive Care Units, Neonatal ; Logistic Models ; Male ; Medicine ; Medicine & Public Health ; Mortality ; Multiple births ; Neonates ; Online databases ; Ontario ; original-article ; Oxygenation ; Patient outcomes ; Patients ; Pediatric Surgery ; Pediatrics ; Performance prediction ; Physiology ; Population ; Probability ; Regression analysis ; Regression models ; Risk analysis ; Risk Assessment ; Risk factors ; ROC Curve ; Severity of Illness Index ; Surgery ; Survival Rate ; Urban Population ; Variables ; Womens health</subject><ispartof>Journal of Perinatology, 2005-05, Vol.25 (5), p.315-319</ispartof><rights>Springer Nature America, Inc. 2005</rights><rights>COPYRIGHT 2005 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group May 2005</rights><rights>Nature Publishing Group 2005.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4207-4bb4a3140574411b9d00613bbe358d7d799c7c36e1fcbab05167a818fed4f7593</citedby><cites>FETCH-LOGICAL-c4207-4bb4a3140574411b9d00613bbe358d7d799c7c36e1fcbab05167a818fed4f7593</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/sj.jp.7211257$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/sj.jp.7211257$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15716986$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Skarsgard, Erik D</creatorcontrib><creatorcontrib>MacNab, Ying C</creatorcontrib><creatorcontrib>Qiu, Zhenguo</creatorcontrib><creatorcontrib>Little, Ruth</creatorcontrib><creatorcontrib>Lee, Shoo K</creatorcontrib><creatorcontrib>Canadian Neonatal Network</creatorcontrib><creatorcontrib>The Canadian Neonatal Network</creatorcontrib><title>SNAP-II Predicts Mortality among Infants with Congenital Diaphragmatic Hernia</title><title>Journal of Perinatology</title><addtitle>J Perinatol</addtitle><addtitle>J Perinatol</addtitle><description>OBJECTIVE:
Outcomes analysis in congenital diaphragmatic hernia (CDH) requires a validated risk-adjustment tool. The purpose of this study was to use the Canadian Neonatal Network (CNN) database to validate the Score for Neonatal Acute Physiology, Version II (SNAP-II) for prediction of mortality among CDH infants admitted to a neonatal intensive care unit (NICU), and to compare this to the predictive equation recently developed by the Congenital Diaphragmatic Hernia Study Group (CDHSG).
STUDY DESIGN:
Infants with CDH in the CNN database were identified. Bivariate and multivariable logistic regression models were used to identify risk factors predictive of mortality. Model predictive performance and calibration were assessed using the area under the receiver operator characteristic curve and the technique of Hosmer-Lemeshow, respectively, and compared with the CDHSG predictive equation.
RESULTS:
There were 88 patients with CDH among 19,507 admissions to CNN hospitals. The mortality rate among CDH patients surviving to NICU admission was 17%, and 12.5% received extracorporeal membrane oxygenation therapy. Gestational age and admission SNAP-II score predicted mortality. Model predictive performance and calibration were optimized with these variables combined. The CDHSG equation was equally predictive of mortality, but was only marginally calibrated.
CONCLUSIONS:
SNAP-II is highly predictive of mortality among patients with CDH, and can be used to risk-adjust these patients.</description><subject>Apgar score</subject><subject>Birth weight</subject><subject>Bivariate analysis</subject><subject>Calibration</subject><subject>Cause of Death</subject><subject>Cohort Studies</subject><subject>Critical Care - standards</subject><subject>Critical Care - trends</subject><subject>Diaphragm</subject><subject>Extracorporeal membrane oxygenation</subject><subject>Female</subject><subject>Gestational age</subject><subject>Health Status Indicators</subject><subject>Hernia</subject><subject>Hernia, Diaphragmatic - diagnosis</subject><subject>Hernia, Diaphragmatic - mortality</subject><subject>Hernias</subject><subject>Hernias, Diaphragmatic, Congenital</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Infants</subject><subject>Intensive care</subject><subject>Intensive Care Units, Neonatal</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Multiple births</subject><subject>Neonates</subject><subject>Online databases</subject><subject>Ontario</subject><subject>original-article</subject><subject>Oxygenation</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Performance prediction</subject><subject>Physiology</subject><subject>Population</subject><subject>Probability</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Risk analysis</subject><subject>Risk Assessment</subject><subject>Risk factors</subject><subject>ROC Curve</subject><subject>Severity of Illness Index</subject><subject>Surgery</subject><subject>Survival Rate</subject><subject>Urban Population</subject><subject>Variables</subject><subject>Womens health</subject><issn>0743-8346</issn><issn>1476-5543</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kkFv1DAQhS0EokvhyBEUgdRbFjt2bOe42gJdqYVKwNlyHGfXUWIH21HVf4-j3XZp1coHSzPfvDejGQDeI7hEEPMvoVt245IVCBUlewEWiDCalyXBL8ECMoJzjgk9AW9C6CCck-w1OEElQ7TidAGufv1YXeebTXbtdWNUDNmV81H2Jt5mcnB2m21sK22K35i4y9Ypoq1JQHZu5LjzcjvIaFR2ob018i141co-6HeH_xT8-fb19_oiv_z5fbNeXeaKFJDlpK6JxIjAkhGCUF01EFKE61rjkjesYVWlmMJUo1bVsoYlokxyxFvdkJaVFT4FZ3vd0bu_kw5RDCYo3ffSajcFQRmriorQBH5-BHZu8jb1Jgo6-zNMi0R9epYqIEFVgflRait7LYxtXfRSzb5ihTjGmDI-Gy6foNJr9GCUs7o1Kf6g4Oy_gp2WfdwF10_ROBsegvkeVN6F4HUrRm8G6W8FgmI-BRE60Y3icAqJ_3gYaqoH3Rzpw-6PrYaUSmv1x6mfU_ywL7AyTl7fK97l_wF2JcOK</recordid><startdate>200505</startdate><enddate>200505</enddate><creator>Skarsgard, Erik D</creator><creator>MacNab, Ying C</creator><creator>Qiu, Zhenguo</creator><creator>Little, Ruth</creator><creator>Lee, Shoo K</creator><general>Nature Publishing Group US</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7RV</scope><scope>7T5</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>200505</creationdate><title>SNAP-II Predicts Mortality among Infants with Congenital Diaphragmatic Hernia</title><author>Skarsgard, Erik D ; MacNab, Ying C ; Qiu, Zhenguo ; Little, Ruth ; Lee, Shoo K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4207-4bb4a3140574411b9d00613bbe358d7d799c7c36e1fcbab05167a818fed4f7593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Apgar score</topic><topic>Birth weight</topic><topic>Bivariate analysis</topic><topic>Calibration</topic><topic>Cause of Death</topic><topic>Cohort Studies</topic><topic>Critical Care - standards</topic><topic>Critical Care - trends</topic><topic>Diaphragm</topic><topic>Extracorporeal membrane oxygenation</topic><topic>Female</topic><topic>Gestational age</topic><topic>Health Status Indicators</topic><topic>Hernia</topic><topic>Hernia, Diaphragmatic - diagnosis</topic><topic>Hernia, Diaphragmatic - mortality</topic><topic>Hernias</topic><topic>Hernias, Diaphragmatic, Congenital</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Infants</topic><topic>Intensive care</topic><topic>Intensive Care Units, Neonatal</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Multiple births</topic><topic>Neonates</topic><topic>Online databases</topic><topic>Ontario</topic><topic>original-article</topic><topic>Oxygenation</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Pediatric Surgery</topic><topic>Pediatrics</topic><topic>Performance prediction</topic><topic>Physiology</topic><topic>Population</topic><topic>Probability</topic><topic>Regression analysis</topic><topic>Regression models</topic><topic>Risk analysis</topic><topic>Risk Assessment</topic><topic>Risk factors</topic><topic>ROC Curve</topic><topic>Severity of Illness Index</topic><topic>Surgery</topic><topic>Survival Rate</topic><topic>Urban Population</topic><topic>Variables</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Skarsgard, Erik D</creatorcontrib><creatorcontrib>MacNab, Ying C</creatorcontrib><creatorcontrib>Qiu, Zhenguo</creatorcontrib><creatorcontrib>Little, Ruth</creatorcontrib><creatorcontrib>Lee, Shoo K</creatorcontrib><creatorcontrib>Canadian Neonatal Network</creatorcontrib><creatorcontrib>The Canadian Neonatal Network</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection (ProQuest)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of Perinatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Skarsgard, Erik D</au><au>MacNab, Ying C</au><au>Qiu, Zhenguo</au><au>Little, Ruth</au><au>Lee, Shoo K</au><aucorp>Canadian Neonatal Network</aucorp><aucorp>The Canadian Neonatal Network</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>SNAP-II Predicts Mortality among Infants with Congenital Diaphragmatic Hernia</atitle><jtitle>Journal of Perinatology</jtitle><stitle>J Perinatol</stitle><addtitle>J Perinatol</addtitle><date>2005-05</date><risdate>2005</risdate><volume>25</volume><issue>5</issue><spage>315</spage><epage>319</epage><pages>315-319</pages><issn>0743-8346</issn><eissn>1476-5543</eissn><abstract>OBJECTIVE:
Outcomes analysis in congenital diaphragmatic hernia (CDH) requires a validated risk-adjustment tool. The purpose of this study was to use the Canadian Neonatal Network (CNN) database to validate the Score for Neonatal Acute Physiology, Version II (SNAP-II) for prediction of mortality among CDH infants admitted to a neonatal intensive care unit (NICU), and to compare this to the predictive equation recently developed by the Congenital Diaphragmatic Hernia Study Group (CDHSG).
STUDY DESIGN:
Infants with CDH in the CNN database were identified. Bivariate and multivariable logistic regression models were used to identify risk factors predictive of mortality. Model predictive performance and calibration were assessed using the area under the receiver operator characteristic curve and the technique of Hosmer-Lemeshow, respectively, and compared with the CDHSG predictive equation.
RESULTS:
There were 88 patients with CDH among 19,507 admissions to CNN hospitals. The mortality rate among CDH patients surviving to NICU admission was 17%, and 12.5% received extracorporeal membrane oxygenation therapy. Gestational age and admission SNAP-II score predicted mortality. Model predictive performance and calibration were optimized with these variables combined. The CDHSG equation was equally predictive of mortality, but was only marginally calibrated.
CONCLUSIONS:
SNAP-II is highly predictive of mortality among patients with CDH, and can be used to risk-adjust these patients.</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><pmid>15716986</pmid><doi>10.1038/sj.jp.7211257</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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source | MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection; SpringerLink Journals - AutoHoldings |
subjects | Apgar score Birth weight Bivariate analysis Calibration Cause of Death Cohort Studies Critical Care - standards Critical Care - trends Diaphragm Extracorporeal membrane oxygenation Female Gestational age Health Status Indicators Hernia Hernia, Diaphragmatic - diagnosis Hernia, Diaphragmatic - mortality Hernias Hernias, Diaphragmatic, Congenital Humans Infant, Newborn Infants Intensive care Intensive Care Units, Neonatal Logistic Models Male Medicine Medicine & Public Health Mortality Multiple births Neonates Online databases Ontario original-article Oxygenation Patient outcomes Patients Pediatric Surgery Pediatrics Performance prediction Physiology Population Probability Regression analysis Regression models Risk analysis Risk Assessment Risk factors ROC Curve Severity of Illness Index Surgery Survival Rate Urban Population Variables Womens health |
title | SNAP-II Predicts Mortality among Infants with Congenital Diaphragmatic Hernia |
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