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An interdisciplinary bronchopulmonary dysplasia program is associated with improved neurodevelopmental outcomes and fewer rehospitalizations

Journal of Perinatology volume 32, pages 33–38 (2012)Cite this article

Abstract

Objective:

Bronchopulmonary dysplasia (BPD) is a pulmonary disease associated with poor neurodevelopmental and medical outcomes. Patients with BPD are medically fragile, at high risk for complications and require interdisciplinary care. We tested the hypothesis that a chronic care approach for BPD would improve neurodevelopmental outcomes relative to the National Institute of Child and Human Development Neonatal Research Network (NICHD NRN) and reduce medical complications.

Study Design:

Infants were followed as inpatients and outpatients. Bayley developmental exams were carried out at 18–24 months of age and compared with the NICHD NRN report. Finally, rates of readmission (a proxy for medical complications) were compared before and after implementation of the Comprehensive Center for BPD (CCBPD).

Result:

Developmental scores obtained in 2007 and 2008 show that 12 and 10% of patients with moderate BPD (n=61) had Bayley Scores <70 for mental and motor indices respectively, whereas corresponding national rates were 35 and 26%. For patients with severe BPD (n=46), 15 and 11% of patients within the CCBPD vs 50 and 42% of national patients scored <70 for mental and motor indices, respectively. Finally, readmission rates dropped from 29% in the year before the implementation of the CCPD (n=269) to 5% thereafter (n=866, P<0.0001).

Conclusion:

The encouraging neurodevelopmental outcomes and readmission rates associated with a chronic care approach to BPD suggest these infants may be best served by a comprehensive interdisciplinary approach to care that focuses on neurodevelopment throughout the hospital stay.

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Acknowledgements

We thank George Mandy, MD, Alicia Moise, MD, Rachel Brown, MD, Angela Gross, RN, BSN, Melissa Hanin, OT for their review of this article. We also thank all of the staff members of the inpatient and outpatient areas of the BPD program at Nationwide Children's Hospital for their dedication to the BPD program.

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Authors and Affiliations

  1. Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA

    E G Shepherd & A M Knupp

  2. Department of Pediatrics, The Baylor College of Medicine, Columbus, Ohio, USA

    S E Welty & A L Gest

  3. Nationwide Children's Hospital & The Ohio State University, Columbus, Ohio, USA

    K M Susey & W P Gardner

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  1. E G Shepherd
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  2. A M Knupp
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Correspondence to E G Shepherd.

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Shepherd, E., Knupp, A., Welty, S. et al. An interdisciplinary bronchopulmonary dysplasia program is associated with improved neurodevelopmental outcomes and fewer rehospitalizations. J Perinatol 32, 33–38 (2012). https://doi.org/10.1038/jp.2011.45

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