RT Journal Article T1 [The binomial symptom index for the evaluation of temporal association between cardiorespiratory symptoms and gastroesophageal reflux in neonates]. T2 El índice de síntomas binomial para la evaluación de la asociación temporal entre síntomas cardiorrespiratorios y reflujo gastroesofágico en neonatos. A1 Barriga-Rivera, Alejandro A1 Moya, María José A1 Lopez-Alonso, Manuel K1 Anti-reflux surgery K1 Análisis de asociación de síntomas K1 Binomial symptom index K1 Cardiorespiratory K1 Cardiorrespiratorio K1 Cirugía antirreflujo K1 Gastroesophageal reflux K1 Neonates K1 Neonatos K1 Probabilidad de asociación de síntomas K1 Reflujo gastroesofágico K1 Symptom association analysis K1 Symptom association probability K1 Índice de síntomas binomial AB The evaluation of symptom association between gastroesophageal reflux and cardiorespiratory events in preterm infants remains unclear. This paper describes a conservative approach to decision-making of anti-reflux surgery through symptom association analysis. Forty-three neonates with potentially reflux-related cardiorespiratory symptoms underwent synchronized esophageal impedance-pH and cardiorespiratory monitoring. Three indices were considered to evaluate symptom association, the symptom index (SI), the symptom sensitivity index (SSI) and the symptom association probability (SAP). A conservative strategy was adopted regarding the decision of anti-reflux surgery, and therefore, patients were scheduled for laparoscopic Nissen fundoplication if the three indices showed a positive assessment of symptom association. Retrospectively, these indices and the binomial symptom index (BSI) were contrasted against the decision of anti-reflux surgery using different windows of association. Thirteen patients showed positive symptom association but only two underwent anti-reflux surgery. The SI and the SSI showed an increasing trend with the width of the window of association. The SAP was affected randomly by slightly altering the windowing parameters. The BSI showed the best performance with the two-minute window (κ =0.78) CONCLUSIONS: The pathology under study is known to improve with maturity. However, the severity of cardiorespiratory symptoms may threaten the neonate's life and therefore, in some occasions, invasive treatments must be considered to protect life. The BSI provides a good prediction of a combination of positive SI, SSI and SAP, which may improve clinical decisions. However, further clinical studies are required to prove the BSI as an optimal predictor of clinical outcomes. YR 2016 FD 2016-01-19 LK http://hdl.handle.net/10668/9771 UL http://hdl.handle.net/10668/9771 LA es DS RISalud RD Apr 7, 2025