Accuracy of the NADAS Criteria in Helping Establish the Diagnosis in Children With Suspected to Have Congenital Heart Disease

Abstract

Background : Prevalence of congenital heart disease is approximately 8/1000 live births and majority of them are diagnosed during evaluation of a murmur detected either during a routine follow-up or while assessment during an intercurrent illness. NADAS criteria can be used as screening test with hight a sensitivity and specificity regarding ability to differentiate pathologic from innocent murmurs.
 Aim : The aim of the study was to assess the accuracy of the NADAS criteria in helping to diagnose disease in children suspected of having congenital heart disease.
 Methods : This was a diagnostic study with a cross-sectional approach and Inclusion criteria were children aged 1 month - 12 years from history and physical examination found a history of recurrent ARI, poor nutritional status, failure to thrive, found cardiac murmurs, without/any cyanosis who attended the outpatient cardiology pediatric at Haji Adam Malik General Hospital between Januari - july 2021. Data Analysis was created using the program IBM SPSS Statistics version 25
 Results : 70 children were screened. 60 children were detected to have CHD. 63,3% of the study population in the age group <5 year had a heart disease. All CHD patients had poor nutritional status, abnormal ECG and 88.33% had a history of recurrent ARI, 80% had abnormal chest x-ray, and 55% had abnormal S2. A grade 3 or higher systolic murmur was found in 78.33% of patients had CHD.
 Conclusion : NADAS criteria can be used as a screening test for helping to diagnose disease in children suspected of having CHD with accuracy 87.14%, sensitivity of 88.33%, specificity was 80% when score at 3 (1 major + 2 minor) and AUC value is 0.842.