EVELINDA MARRAMON TRINDADE

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PAHC, Hospital das Clínicas, Faculdade de Medicina

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  • article 22 Citação(ões) na Scopus
    Improving preoperative risk-of-death prediction in surgery congenital heart defects using artificial intelligence model: A pilot study
    (2020) CHANG JUNIOR, Joao; BINUESA, Fabio; CANEO, Luiz Fernando; TURQUETTO, Aida Luiza Ribeiro; ARITA, Elisandra Cristina Trevisan Calvo; BARBOSA, Aline Cristina; FERNANDES, Alfredo Manoel da Silva; TRINDADE, Evelinda Marramon; JATENE, Fabio Biscegli; DOSSOU, Paul-Eric; JATENE, Marcelo Biscegli
    Background Congenital heart disease accounts for almost a third of all major congenital anomalies. Congenital heart defects have a significant impact on morbidity, mortality and health costs for children and adults. Research regarding the risk of pre-surgical mortality is scarce. Objectives Our goal is to generate a predictive model calculator adapted to the regional reality focused on individual mortality prediction among patients with congenital heart disease undergoing cardiac surgery. Methods Two thousand two hundred forty CHD consecutive patients' data from InCor's heart surgery program was used to develop and validate the preoperative risk-of-death prediction model of congenital patients undergoing heart surgery. There were six artificial intelligence models most cited in medical references used in this study: Multilayer Perceptron (MLP), Random Forest (RF), Extra Trees (ET), Stochastic Gradient Boosting (SGB), Ada Boost Classification (ABC) and Bag Decision Trees (BDT). Results The top performing areas under the curve were achieved using Random Forest (0.902). Most influential predictors included previous admission to ICU, diagnostic group, patient's height, hypoplastic left heart syndrome, body mass, arterial oxygen saturation, and pulmonary atresia. These combined predictor variables represent 67.8% of importance for the risk of mortality in the Random Forest algorithm. Conclusions The representativeness of ""hospital death"" is greater in patients up to 66 cm in height and body mass index below 13.0 for InCor's patients. The proportion of ""hospital death"" declines with the increased arterial oxygen saturation index. Patients with prior hospitalization before surgery had higher ""hospital death"" rates than who did not required such intervention. The diagnoses groups having the higher fatal outcomes probability are aligned with the international literature. A web application is presented where researchers and providers can calculate predicted mortality based on the CgntSCORE on any web browser or smartphone.
  • conferenceObject
    Impact of Histidine-Tryptophan-Ketoglutarate Preservation Solution in Heart Transplantation with Extended Distance
    (2020) GONCALVES, F. A. Rodrigues; TRINDADE, E. M.; MANGINI, S.; GAIOTTO, F.; BACAL, F.
  • article 37 Citação(ões) na Scopus
    Growth hormone treatment in Prader-Willi syndrome patients: systematic review and meta-analysis
    (2020) PASSONE, Caroline de Gouveia Buff; FRANCO, Ruth Rocha; ITO, Simone Sakura; TRINDADE, Evelinda; POLAK, Michel; DAMIANI, Durval; BERNARDO, Wanderley Marques
    Background Growth hormone (GH) treatment is currently recommended in Prader-Willi syndrome (PWS) patients. Objectives To evaluate the impact (efficacy and safety) of the use of recombinant human GH (rhGH) as a treatment for PWS. Method We performed a systematic review and, where possible, meta-analysis for the following outcomes: growth, body mass index, body composition, cognitive function, quality of life, head circumference, motor development/strength, behaviour and adverse effects. We included all PWS patients, with all types of genetic defects and with or without GH deficiency, who participated in rhGH studies performed in infancy, childhood and adolescence, that were either randomised controlled trials (RCTs) (double-blinded or not) or non-randomised controlled trials (NRCTs) (cohort and before and after studies). The databases used were MEDLINE, Embase and Cochrane Central. Results In 16 RCTs and 20 NRCTs selected, the treated group had an improvement in height (1.67 SD scores (SDS); 1.54 to 1.81); body mass index z-scores (-0.67 SDS; -0.87 to -0.47) and fat mass proportion (-6.5% SDS; -8.46 to -4.54) compared with the control group. Data about cognition could not be aggregated. Conclusion Based on high quality evidence, rhGH treatment favoured an improvement of stature, body composition and body mass index, modifying the disease's natural history; rhGH treatment may also be implicated in improved cognition and motor development in PWS patients at a young age. Ethics and dissemination The current review was approved by the ethical committee of our institution. The results will be disseminated through conference presentations and publications in peer-reviewed journals. PROSPERO registration number CRD42019140295