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CART Models of Ambalavanan et al for Predicting Outcome in a Neonate with Hypoxic-Ischemic Encephalopathy (HIE)

Description

Ambalavanan et al developed CART (classification and regression tree) models for predicting the outcome in a neonate with hypoxic-ischemic encephalopathy. This can help identify an infant who requires more aggressive management. The authors are from multiple universities in the United States participating in the National Institute of Child Health and Human Development Neonatal Research Network.


 

Outcome scores:

(1) death or disability

(2) death

 

Parameters:

(1) pH in cord blood gas

(2) PaCO2 in mm Hg in cord blood gas

(3) base deficit in first postnatal arterial blood gas in mmol/L (acidosis)

(4) spontaneous activity

 

CART model for disability or death

 

pH

spontaneous activity

base deficit

PaCO2

Probability

<= 6.7

NA

NA

NA

91%

> 6.7

N

NA

NA

76%

> 6.7

Y

> 18.5

NA

55%

> 6.7

Y

<= 18.5

<= 87 mm Hg

32%

> 6.7

Y

<= 18.5

> 87 mm Hg

12%

 

where:

• The lower probability associated with a higher PaCO2 in the final node is not intuitive.

 

CART model for death

 

base deficit

pH

Probability

> 24.5 mmol/L

NA

72%

<= 24.5 mmol/L

<= 6.74

48%

<= 24.5 mmol/L

> 6.74

15%

 


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