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In-hospital outcomes of late referrals for established bronchopulmonary dysplasia

Journal of Perinatology volume 41, pages 1972–1982 (2021)Cite this article

Subjects

Abstract

Objective

To determine the in-hospital outcomes for patients with established bronchopulmonary dysplasia (BPD) referred late for severe disease.

Study design

Retrospective cohort study of patients with established BPD referred to our center after 36 weeks PMA.

Result

Among 71 patients with BPD referred to our center after 36 weeks PMA between 2010 and 2018, the median PMA was 47 weeks (IQR, 42, 53) and the median respiratory severity score was 8.1 (IQR 4.5, 11.0) on admission. Survival in this cohort was 92%. Most survivors were discharged home without the need for positive pressure respiratory support (77%) or pulmonary vasodilators (89%). For survivors, we observed a significant improvement in median z-scores for length (−6.7 vs −3.3, p < 0.0001) between admission and discharge.

Conclusion

Despite presenting relatively late with a high degree of illness severity, nearly all patients in this cohort survived to hospital discharge with improvement in comorbidities.

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Fig. 1: Change in RSS over time following admission, stratified by survival status.
Fig. 2: Kaplan–Meier curves for the proportion of the cohort remaining on positive pressure over time following admission.
Fig. 3: Change in z-scores for growth parameters between survival and discharge.

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Author information

Authors and Affiliations

  1. Comprehensive Center for Bronchopulmonary Dysplasia, Nationwide Children’s Hospital, Columbus, OH, USA

    Matthew J. Kielt, J. Wells Logan, Kristina M. Reber, Leif D. Nelin & Edward G. Shepherd

  2. Division of Neonatology, Nationwide Children’s Hospital, Columbus, OH, USA

    Matthew J. Kielt, J. Wells Logan, Carl H. Backes, Kristina M. Reber, Leif D. Nelin & Edward G. Shepherd

  3. Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA

    Matthew J. Kielt, J. Wells Logan, Carl H. Backes, Kristina M. Reber, Leif D. Nelin & Edward G. Shepherd

  4. Center for Perinatal Research, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA

    Carl H. Backes & Leif D. Nelin

  5. The Heart Center, Nationwide Children’s Hospital, Columbus, OH, USA

    Carl H. Backes

  6. Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, USA

    Carl H. Backes

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  1. Matthew J. Kielt
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Contributions

MJK conceptualized and designed the study, collected, analyzed and interpreted the data, drafted the initial manuscript, and reviewed and revised the final manuscript; JWL contributed to analysis and interpretation of the data, contributed to drafting of the initial manuscript, and reviewed and revised the final manuscript. CHB read and interpreted clinical echocardiograms, reviewed the manuscript for important intellectual content, and reviewed and revised the final manuscript. KMR contributed to conceptualization of the study, contributed to interpretation of the data, reviewed the manuscript for important intellectual content, and revised and reviewed the final manuscript. LDN and EGS conceptualized and designed the study, coordinated and supervised data collection, assisted in statistical analysis, contributed to initial drafts of the manuscript, and reviewed and revised the final manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Matthew J. Kielt.

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Kielt, M.J., Logan, J.W., Backes, C.H. et al. In-hospital outcomes of late referrals for established bronchopulmonary dysplasia. J Perinatol 41, 1972–1982 (2021). https://doi.org/10.1038/s41372-021-01041-6

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