Prognosis of Pediatric Dilated Cardiomyopathy: Nomogram and Risk Score Models for Predicting Death/Heart Transplantation

<b>Background:</b> This study aimed to develop a predictive model to assess risk factors and prognoses in pediatric patients with dilated cardiomyopathy (DCM). <b>Methods:</b> A total of 233 pediatric patients with DCM who were hospitalized between January 2019 and June 2024...

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Main Authors: Bowen Xu, Yue Yuan, Lu Gao, Zhiyuan Wang, Zhenyu Lv, Wen Yu, Hongfang Jin, Zhen Zhen, Zhihui Zhao, Jia Na, Aihua Hu, Yanyan Xiao
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Children
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Online Access:https://www.mdpi.com/2227-9067/12/7/880
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author Bowen Xu
Yue Yuan
Lu Gao
Zhiyuan Wang
Zhenyu Lv
Wen Yu
Hongfang Jin
Zhen Zhen
Zhihui Zhao
Jia Na
Aihua Hu
Yanyan Xiao
author_facet Bowen Xu
Yue Yuan
Lu Gao
Zhiyuan Wang
Zhenyu Lv
Wen Yu
Hongfang Jin
Zhen Zhen
Zhihui Zhao
Jia Na
Aihua Hu
Yanyan Xiao
author_sort Bowen Xu
collection DOAJ
description <b>Background:</b> This study aimed to develop a predictive model to assess risk factors and prognoses in pediatric patients with dilated cardiomyopathy (DCM). <b>Methods:</b> A total of 233 pediatric patients with DCM who were hospitalized between January 2019 and June 2024 were enrolled. The children were followed up and categorized into two groups: the death/heart transplantation (D/HT) group and the non-D/HT group. Univariate and multivariate analyses identified risk factors. A nomogram model and a scoring system were developed. The performance of these models was evaluated using the H-L test, ROC analysis, and internal validation. <b>Results:</b> The results demonstrated that the age of onset, cardiac functional classification III–IV, moderate-to-severe mitral regurgitation, low voltage in limb leads on an ECG, and the need for vasoactive drugs are independent predictors of D/HT risk in children with DCM. A nomogram model was developed, achieving an AUC of 0.804 (95% CI: 0.734–0.874), a sensitivity of 80.3%, and a specificity of 66.7%. A scoring system was established: 1 point for age of onset, 10 points for cardiac functional classification III–IV, 2.5 points for moderate-to-severe mitral regurgitation, 4 points for low voltage in limb leads on an ECG, 3 points for the need for vasoactive drugs, or 0 points if none of these criteria were met. When the cumulative score was ≥ 13.25, the sensitivity and specificity increased to 68.9% and 73.9%, respectively. <b>Conclusions:</b> We developed both a nomogram and a scoring system model, which are capable of rapidly and accurately predicting the risk of D/HT in children with DCM.
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spelling doaj-art-924ceb4fc14f4d2bb5edafea7e151efa2025-08-20T02:45:38ZengMDPI AGChildren2227-90672025-07-0112788010.3390/children12070880Prognosis of Pediatric Dilated Cardiomyopathy: Nomogram and Risk Score Models for Predicting Death/Heart TransplantationBowen Xu0Yue Yuan1Lu Gao2Zhiyuan Wang3Zhenyu Lv4Wen Yu5Hongfang Jin6Zhen Zhen7Zhihui Zhao8Jia Na9Aihua Hu10Yanyan Xiao11Department of Cardiology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing 100045, ChinaDepartment of Cardiology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing 100045, ChinaDepartment of Cardiology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing 100045, ChinaDepartment of Cardiology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing 100045, ChinaDepartment of Cardiology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing 100045, ChinaDepartment of Cardiology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing 100045, ChinaDepartment of Pediatrics, Peking University First Hospital, Beijing 100034, ChinaDepartment of Cardiology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing 100045, ChinaDepartment of Cardiology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing 100045, ChinaDepartment of Cardiology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing 100045, ChinaPediatric Chronic Disease Management Center, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing 100045, ChinaDepartment of Cardiology, Beijing Children’s Hospital, National Center for Children’s Health, Capital Medical University, Beijing 100045, China<b>Background:</b> This study aimed to develop a predictive model to assess risk factors and prognoses in pediatric patients with dilated cardiomyopathy (DCM). <b>Methods:</b> A total of 233 pediatric patients with DCM who were hospitalized between January 2019 and June 2024 were enrolled. The children were followed up and categorized into two groups: the death/heart transplantation (D/HT) group and the non-D/HT group. Univariate and multivariate analyses identified risk factors. A nomogram model and a scoring system were developed. The performance of these models was evaluated using the H-L test, ROC analysis, and internal validation. <b>Results:</b> The results demonstrated that the age of onset, cardiac functional classification III–IV, moderate-to-severe mitral regurgitation, low voltage in limb leads on an ECG, and the need for vasoactive drugs are independent predictors of D/HT risk in children with DCM. A nomogram model was developed, achieving an AUC of 0.804 (95% CI: 0.734–0.874), a sensitivity of 80.3%, and a specificity of 66.7%. A scoring system was established: 1 point for age of onset, 10 points for cardiac functional classification III–IV, 2.5 points for moderate-to-severe mitral regurgitation, 4 points for low voltage in limb leads on an ECG, 3 points for the need for vasoactive drugs, or 0 points if none of these criteria were met. When the cumulative score was ≥ 13.25, the sensitivity and specificity increased to 68.9% and 73.9%, respectively. <b>Conclusions:</b> We developed both a nomogram and a scoring system model, which are capable of rapidly and accurately predicting the risk of D/HT in children with DCM.https://www.mdpi.com/2227-9067/12/7/880dilated cardiomyopathydeathheart transplantationpredictive modelchildren
spellingShingle Bowen Xu
Yue Yuan
Lu Gao
Zhiyuan Wang
Zhenyu Lv
Wen Yu
Hongfang Jin
Zhen Zhen
Zhihui Zhao
Jia Na
Aihua Hu
Yanyan Xiao
Prognosis of Pediatric Dilated Cardiomyopathy: Nomogram and Risk Score Models for Predicting Death/Heart Transplantation
Children
dilated cardiomyopathy
death
heart transplantation
predictive model
children
title Prognosis of Pediatric Dilated Cardiomyopathy: Nomogram and Risk Score Models for Predicting Death/Heart Transplantation
title_full Prognosis of Pediatric Dilated Cardiomyopathy: Nomogram and Risk Score Models for Predicting Death/Heart Transplantation
title_fullStr Prognosis of Pediatric Dilated Cardiomyopathy: Nomogram and Risk Score Models for Predicting Death/Heart Transplantation
title_full_unstemmed Prognosis of Pediatric Dilated Cardiomyopathy: Nomogram and Risk Score Models for Predicting Death/Heart Transplantation
title_short Prognosis of Pediatric Dilated Cardiomyopathy: Nomogram and Risk Score Models for Predicting Death/Heart Transplantation
title_sort prognosis of pediatric dilated cardiomyopathy nomogram and risk score models for predicting death heart transplantation
topic dilated cardiomyopathy
death
heart transplantation
predictive model
children
url https://www.mdpi.com/2227-9067/12/7/880
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