Original Article

Journal of Perinatology (2008) 28, 420–426; doi:10.1038/jp.2008.18; published online 13 March 2008

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

N Ambalavanan1, K P Van Meurs2, R Perritt3, W A Carlo1, R A Ehrenkranz4, D K Stevenson2, J A Lemons5, W K Poole3 and R D Higgins6 for the NICHD Neonatal Research Network, Bethesda, MD

  1. 1Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA
  2. 2Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
  3. 3RTI International, Research Triangle Park, NC, USA
  4. 4Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
  5. 5Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
  6. 6National Institute of Child Health and Human Development Neonatal Research Network, Bethesda, MD, USA

Correspondence: Dr N Ambalavanan, Department of Pediatrics, University of Alabama at Birmingham, 525 New Hillman Building, 619 South 20th Street, Birmingham, AL 35249, USA. E-mail: ambal@uab.edu

Received 23 August 2007; Revised 11 January 2008; Accepted 4 February 2008; Published online 13 March 2008.

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Abstract

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 (O2 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 PaO2 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.

Keywords:

logistic models, predictive value of tests, ROC curve

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