{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T08:47:03Z","timestamp":1770454023699,"version":"3.49.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,11,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">We aimed to develop and validate a prediction model for in\u2010hospital complications in children with tetralogy of Fallot repaired at an older age.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A total of 513 pediatric patients from the Tianjin data set formed a derivation cohort, and 158 pediatric patients from the Hefei and Xiamen data sets formed validation cohorts. We applied least absolute shrinkage and selection operator analysis for variable selection and logistic regression coefficients for risk scoring. We classified patients into different risk categorizations by threshold analysis and investigated the association with in\u2010hospital complications using\u00a0logistic regression. In\u2010hospital complications were defined as death, need for extensive pharmacologic support (vasoactive\u2010inotrope score of \u226520), and need for mechanical circulatory support. We developed a nomogram based on risk classifier and independent baseline variables using a multivariable logistic model. Based on risk scores weighted by 11 preoperative and 4 intraoperative selected variables, we classified patients as low, intermediate, and high risk in the derivation cohort. With reference to the low\u2010risk group, the intermediate\u2010 and high\u2010risk groups conferred significantly higher in\u2010hospital complication risks (adjusted odds ratio: 2.721 [95% CI, 1.267\u20135.841],\n              <jats:italic>P<\/jats:italic>\n              =0.0102; 9.297 [95% CI, 4.601\u201318.786],\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001). A nomogram integrating the\n              <jats:styled-content style=\"fixed-case\">ARIAR<\/jats:styled-content>\n              \u2010Risk classifier (absolute and relative low risk, intermediate risk, and aggressive and refractory high risk) with age and mean blood pressure showed good discrimination and goodness\u2010of\u2010fit for derivation (area under the receiver operating characteristic curve: 0.785 [95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 0.731\u20130.839]; Hosmer\u2010Lemeshow test,\n              <jats:italic>P<\/jats:italic>\n              =0.544) and external validation (area under the receiver operating characteristic curve: 0.759 [95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 0.636\u20130.881]; Hosmer\u2010Lemeshow test,\n              <jats:italic>P<\/jats:italic>\n              =0.508).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">A risk\u2010classifier\u2013oriented nomogram is a reliable prediction model for in\u2010hospital complications in children with tetralogy of Fallot repaired at an older age, and strengthens risk\/benefit\u2013based decision\u2010making.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.013388","type":"journal-article","created":{"date-parts":[[2019,10,24]],"date-time":"2019-10-24T12:41:09Z","timestamp":1571920869000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Derivation and Validation of a Nomogram to Predict In\u2010Hospital Complications in Children with Tetralogy of Fallot Repaired at an Older Age"],"prefix":"10.1161","volume":"8","author":[{"given":"Hong","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery TEDA International Cardiovascular Hospital Chinese Academy of Medical Sciences &amp; Peking Union Medical College Tianjin China"},{"name":"Department of Cardiovascular Surgery First Hospital of Nanjing Medical University Nanjing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Si\u2010qiang","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery TEDA International Cardiovascular Hospital Chinese Academy of Medical Sciences &amp; Peking Union Medical College Tianjin China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin\u2010ya","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery the First Hospital of University of Science and Technology of China Hefei China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi\u2010hua","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery TEDA International Cardiovascular Hospital Chinese Academy of Medical Sciences &amp; Peking Union Medical College Tianjin China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji\u2010sheng","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Xiamen Cardiovascular Hospital Xiamen University Xiamen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun\u2010quan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery TEDA International Cardiovascular Hospital Chinese Academy of Medical Sciences &amp; Peking Union Medical College Tianjin China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery TEDA International Cardiovascular Hospital Chinese Academy of Medical Sciences &amp; Peking Union Medical College Tianjin China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi\u2010gang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery TEDA International Cardiovascular Hospital Chinese Academy of Medical Sciences &amp; Peking Union Medical College Tianjin China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao\u2010cheng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery TEDA International Cardiovascular Hospital Chinese Academy of Medical Sciences &amp; Peking Union Medical College Tianjin China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong\u2010feng","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery First Hospital of Nanjing Medical University Nanjing China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60657-7"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199308263290901"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.111.963603"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2010.03.110"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.2174\/1570161113666151014123718"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951113001686"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4471-4619-3_98"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccl.2015.07.002"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.926808"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/1089253208323681"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2006.04.001"},{"key":"e_1_3_2_13_2","first-page":"3276","article-title":"Relationship between type of outflow tract repair and postoperative right ventricular diastolic physiology in tetralogy of Fallot","volume":"94","author":"Norg\u00e5rd G","year":"1996","unstructured":"Norg\u00e5rd G, Gatzoulis MA, Moraes F, Lincoln C, Shore DF, Shinebourne EA, Redington AN. 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