Journal article
A Patent Ductus Arteriosus Severity Score Predicts Chronic Lung Disease or Death before Discharge
The Journal of pediatrics, Vol.167(6), pp.1354-1361.e2
12/2015
DOI: 10.1016/j.jpeds.2015.09.028
PMID: 26474706
Abstract
To test the hypothesis that a patent ductus arteriosus (PDA) severity score (PDAsc) incorporating markers of pulmonary overcirculation and left ventricular (LV) diastolic function can predict chronic lung disease or death before discharge (CLD/death).
A multicenter prospective observational study was conducted for infants <29 weeks gestation. An echocardiogram was carried out on day 2 to measure PDA diameter and maximum flow velocity, LV output, diastolic flow in the descending aorta and celiac trunk, and variables of LV function using tissue Doppler imaging. Predictors of CLD/death were identified using logistic regression methods. A PDAsc was created and a receiver operating characteristic curve was constructed to assess its ability to predict CLD/death.
We studied 141 infants at a mean (SD) gestation and birthweight of 26 (1.4) weeks and 952 (235) g, respectively. Five variables were identified that were independently associated with CLD/death (gestation at birth, PDA diameter, maximum flow velocity, LV output, and LV a' wave). The PDAsc had a range from 0 (low risk) to 13 (high risk). Infants who developed CLD/death had a higher score than those who did not (7.3 [1.8] vs 3.8 [2.0], P < .001). PDAsc had an area under the curve of 0.92 (95% CI 0.86-0.97, P < .001) for the ability to predict CLD/death. A PDAsc cut-off of 5 has sensitivity and specificity of 92% and 87%, and positive and negative predictive values of 92% and 82%, respectively.
A PDAsc on day 2 can predict the later occurrence of CLD/death further highlighting the association between PDA significance and morbidity.
Details
- Title: Subtitle
- A Patent Ductus Arteriosus Severity Score Predicts Chronic Lung Disease or Death before Discharge
- Creators
- Afif El-Khuffash - Department of Neonatology, The Rotunda Hospital, Dublin, Ireland; Department of Pediatrics, The Royal College of Surgeons in Ireland, Dublin, Ireland. Electronic address: afifelkhuffash@rcsi.ieAdam T James - Department of Neonatology, The Rotunda Hospital, Dublin, IrelandJohn David Corcoran - Department of Neonatology, The Rotunda Hospital, Dublin, Ireland; Department of Pediatrics, The Royal College of Surgeons in Ireland, Dublin, IrelandPatrick Dicker - Department of Biostatistics, The Royal College of Surgeons in Ireland, Dublin, IrelandOrla Franklin - Department of Pediatric Cardiology, Our Lady's Children's Hospital Crumlin, Dublin, IrelandYasser N Elsayed - Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, CanadaJoseph Y Ting - Department of Pediatrics, University of British Columbia, Vancouver, British Colombia, CanadaArvind Sehgal - Monash Newborn, Monash Children's Hospital, Melbourne, Australia; Department of Pediatrics, Monash University, Melbourne, AustraliaAndra Malikiwi - Monash Newborn, Monash Children's Hospital, Melbourne, AustraliaAndrei Harabor - Department of Pediatrics, University of Calgary, Calgary, Alberta, CanadaAmuchou S Soraisham - Department of Pediatrics, University of Calgary, Calgary, Alberta, CanadaPatrick J McNamara - Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada; Departments of Physiology and Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Resource Type
- Journal article
- Publication Details
- The Journal of pediatrics, Vol.167(6), pp.1354-1361.e2
- DOI
- 10.1016/j.jpeds.2015.09.028
- PMID
- 26474706
- ISSN
- 0022-3476
- eISSN
- 1097-6833
- Language
- English
- Date published
- 12/2015
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology; Internal Medicine
- Record Identifier
- 9984093457202771
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