Visualization of Risk Factors and Predictive Models for Early Death of Neonatal Gastric Perforation

Clin Pediatr (Phila). 2024 Jul;63(7):986-994. doi: 10.1177/00099228231201315. Epub 2023 Sep 26.

Abstract

A retrospective analysis was performed from May 2003 to October 2021 at our hospital. One hundred and eleven neonates diagnosed with gastric perforation were categorized into non-survivor and survivor groups based on prognosis. The mortality rate was 23.42%. Logistic regression was used to analyze the factors influencing the early neonatal death. The non-survivor groups showed more abdominal distension, vomiting, hypoxia, acidosis, hyperkalemia, and coagulation abnormalities. Serum potassium concentration (odds ratio [OR] 2.148, P = .043) was an independent risk factor; however, arterial partial pressure of oxygen (OR 0.977, P = .024), bicarbonate (OR 0.779, P = .023), and platelet count (OR 0.986, P = .014) had protective effects on neonatal death. Based on this, a visualized nomogram prediction model was constructed, patients who had a nomogram score of more than 163.787 was considered to have high risks of mortality, the area under the curve of this was up to 0.828 (95% confidence interval [0.733, 0.923]), the sensitivity was 80.0%, and the specificity was 76.9%.

Keywords: laparotomy; mortality; neonatal gastric perforation; nomogram model; risk factors.

MeSH terms

  • Female
  • Humans
  • Infant, Newborn
  • Logistic Models
  • Male
  • Nomograms*
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Stomach Rupture