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Konjenital diafragma hernisinde yaşam prediktörleri: 10 yıllık deneyimin multivariate analizi

Survival Predictors In Congenital Diaphragmatic Hernia: Multivariate Analysis Of a 10-Year Experience

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Abstract (2. Language): 
The purpose of this study was to establish a method by which independent predictors of survival could be determined and used to select CDHpatients who may benefit from rescue therapy. Data from our 10-year, single institutional experience of 62 infants with CDH were analyzed. Fifteen preoperative and seven intraoperative variables were analyzed. Stepwise logistic regression analysis yielded a prediction equation with four independent, statistically significant (P<0.05) predictors of survival: lower VI, higher BW, higher 5-minute APGAR, and lower PaCO2. Using a survival probability of <20%, this equation yielded a sensitivity of 94% and specificity of 82% in selecting those patients with CDH who failed conventional management. We conclude that the preoperative values for VI, BW, 5-minute APGAR, and PaCO2 of neonates with CDH in our institution can be used to select those patients with predicted high mortality who may benefit from salvage therapy. [Journal of Turgut Özal Medical Center 1997;4(2):225-229]
Abstract (Original Language): 
Bu çalışmanın amacı KDH'li hastalarda kurtarma tedavisine almak için hangi bağımsız yaşam prediktörlerinin olduğunun ve kullanılabileceğinin tespiti için bir metod geliştirmekti. Merkezimizin 10 yıllık bir süredeki 62 hastasının verileri analiz edildi. 15 preoperatif ve 7 intraoperatif değişken incelendi. Stepwise lojistik regresyon analizi dört adet bağımsız, istatistiksel olarak anlamlı (P<0.05) yaşam prediktörü olduğu sonucunu verdi: düşük VI, yüksek DA, yüksek 5 dakika APGAR sonucu ve düşük PaC02. Yaşam probabilitesi %20'den küçük kriterini kullanarak yapılan değerlendirme konvansiyel tedaviden fayda görmeyecek KDH'li vakaların değerlendirilmesinde %94 sensitivite ve %82 spesifite sonucunu verdi. Sonuç olarak VI in preoperatif değeri, DA, 5 dakika APGAR, ve PaC02 kurtarma tedavisinden fayda görebilecek, yüksek mor t al it e öngörülen yenidoğanların seçiminde kullanılabilir düşüncesindeyiz. [Turgut Özal Tıp Merkezi Dergisi 1997;4(2):225-229]

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