Predictors of death or bronchopulmonary dysplasia in preterm infants with respiratory failure

• Published in: Journal of perinatology Vol. 28; no. 6; pp. 420 - 426
• Main Authors: Ambalavanan, N, Van Meurs, K P, Perritt, R, Carlo, W A, Ehrenkranz, R A, Stevenson, D K, Lemons, J A, Poole, W K, Higgins, R D
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.06.2008; Nature Publishing Group
• Subjects: Algorithms; Birth weight; Bronchopulmonary dysplasia; Bronchopulmonary Dysplasia - epidemiology; Childrens health; Death; Diagnosis; Dysplasia; Gender; Health aspects; Humans; Infant, Newborn; Infant, Premature; Infants; Infants (Premature); Logistic Models; Lung diseases; Males; Medical prognosis; Medicine; Medicine & Public Health; Menstruation; Models, Statistical; Mortality; Neonates; Newborn babies; Nitric oxide; original-article; Oxygenation; Pediatric Surgery; Pediatrics; Premature babies; Premature birth; Regression analysis; Regression models; Respiratory distress syndrome; Respiratory failure; Respiratory Insufficiency - epidemiology; Respiratory Insufficiency - mortality; Risk factors; Secondary analysis; Software; Statistical analysis; Surfactants; Variables; Ventilators; United States > US; logistic models; predictive value of tests; ROC curve
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/jp.2008.18

Objectives: To identify the variables that predict death/physiologic bronchopulmonary dysplasia (BPD) in preterm infants with severe respiratory failure. Study Design: The study was a secondary analysis of data from the NICHD Neonatal Research Network trial of inhaled nitric oxide (iNO) in preterm infants. Stepwise logistic regression models and Classification and Regression Tree (CART) models were developed for the outcome of death or physiologic BPD (O 2 at 36 weeks post-menstrual age). Result: Death and/or BPD was associated with lower birth weight, higher oxygen requirement, male gender, additional surfactant doses, higher oxygenation index and outborn status, but not the magnitude of response in PaO 2 to iNO. The positive predictive value of the CART model was 82% at 95% sensitivity. Conclusions: The major factors associated with death/BPD were an increased severity of respiratory failure, lower birth weight, male gender and outborn status, but not the magnitude of initial response to iNO.