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The Bayley-III scale may underestimate neurodevelopmental disability after cardiac surgery in infants.

Publication ,  Journal Article
Goldstone, AB; Baiocchi, M; Wypij, D; Stopp, C; Andropoulos, DB; Atallah, J; Atz, AM; Beca, J; Donofrio, MT; Duncan, K; Ghanayem, NS; Justo, R ...
Published in: Eur J Cardiothorac Surg
January 1, 2020

OBJECTIVES: Neurodevelopmental disability is the most common complication among congenital heart surgery survivors. The Bayley scales are standardized instruments to assess neurodevelopment. The most recent edition (Bayley Scales of Infant and Toddler Development 3rd Edition, Bayley-III) yields better-than-expected scores in typically developing and high-risk infants than the second edition (Bayley Scales of Infant Development 2nd Edition, BSID-II). We compared BSID-II and Bayley-III scores in infants undergoing cardiac surgery. METHODS: We evaluated 2198 infants who underwent operations with cardiopulmonary bypass between 1996 and 2009 at 26 institutions. We used propensity score matching to limit confounding by indication in a subset of patients (n = 705). RESULTS: Overall, unadjusted Bayley-III motor scores were higher than BSID-II Psychomotor Development Index scores (90.7 ± 17.2 vs 77.6 ± 18.8, P < 0.001), and unadjusted Bayley-III composite cognitive and language scores were higher than BSID-II Mental Development Index scores (92.0 ± 15.4 vs 88.2 ± 16.7, P < 0.001). In the propensity-matched analysis, Bayley-III motor scores were higher than BSID-II Psychomotor Development Index scores [absolute difference 14.1, 95% confidence interval (CI) 11.7-17.6; P < 0.001] and the Bayley-III classified fewer children as having severe [odds ratio (OR) 0.24; 95% CI 0.14-0.42] or mild-to-moderate impairment (OR 0.21; 95% CI 0.14-0.32). The composite of Bayley-III cognitive and language scores was higher than BSID-II Mental Development Index scores (absolute difference 4.0, 95% CI 1.4-6.7; P = 0.003), but there was no difference between Bayley editions in the proportion of children classified as having severe cognitive and language impairment. CONCLUSIONS: The Bayley-III yielded higher scores than the BSID-II and classified fewer children as severely impaired. The systematic bias towards higher scores with the Bayley-III precludes valid comparisons between early and contemporary cardiac surgery cohorts.

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Published In

Eur J Cardiothorac Surg

DOI

EISSN

1873-734X

Publication Date

January 1, 2020

Volume

57

Issue

1

Start / End Page

63 / 71

Location

Germany

Related Subject Headings

  • Respiratory System
  • Infant
  • Humans
  • Developmental Disabilities
  • Child Development
  • Child
  • Cardiopulmonary Bypass
  • Cardiac Surgical Procedures
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology
 

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Goldstone, A. B., Baiocchi, M., Wypij, D., Stopp, C., Andropoulos, D. B., Atallah, J., … Gaynor, J. W. (2020). The Bayley-III scale may underestimate neurodevelopmental disability after cardiac surgery in infants. Eur J Cardiothorac Surg, 57(1), 63–71. https://doi.org/10.1093/ejcts/ezz123
Goldstone, Andrew B., Michael Baiocchi, David Wypij, Christian Stopp, Dean B. Andropoulos, Joseph Atallah, Andrew M. Atz, et al. “The Bayley-III scale may underestimate neurodevelopmental disability after cardiac surgery in infants.Eur J Cardiothorac Surg 57, no. 1 (January 1, 2020): 63–71. https://doi.org/10.1093/ejcts/ezz123.
Goldstone AB, Baiocchi M, Wypij D, Stopp C, Andropoulos DB, Atallah J, et al. The Bayley-III scale may underestimate neurodevelopmental disability after cardiac surgery in infants. Eur J Cardiothorac Surg. 2020 Jan 1;57(1):63–71.
Goldstone, Andrew B., et al. “The Bayley-III scale may underestimate neurodevelopmental disability after cardiac surgery in infants.Eur J Cardiothorac Surg, vol. 57, no. 1, Jan. 2020, pp. 63–71. Pubmed, doi:10.1093/ejcts/ezz123.
Goldstone AB, Baiocchi M, Wypij D, Stopp C, Andropoulos DB, Atallah J, Atz AM, Beca J, Donofrio MT, Duncan K, Ghanayem NS, Goldberg CS, Hövels-Gürich H, Ichida F, Jacobs JP, Justo R, Latal B, Li JS, Mahle WT, McQuillen PS, Menon SC, Pike NA, Pizarro C, Shekerdemian LS, Synnes A, Williams IA, Bellinger DC, Newburger J, Gaynor JW. The Bayley-III scale may underestimate neurodevelopmental disability after cardiac surgery in infants. Eur J Cardiothorac Surg. 2020 Jan 1;57(1):63–71.
Journal cover image

Published In

Eur J Cardiothorac Surg

DOI

EISSN

1873-734X

Publication Date

January 1, 2020

Volume

57

Issue

1

Start / End Page

63 / 71

Location

Germany

Related Subject Headings

  • Respiratory System
  • Infant
  • Humans
  • Developmental Disabilities
  • Child Development
  • Child
  • Cardiopulmonary Bypass
  • Cardiac Surgical Procedures
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology