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The Optimal State Scoring Tool: guidance for interdisciplinary care of infants with severe bronchopulmonary dysplasia and its relation to linear growth

Journal of Perinatology volume 43, pages 1301–1307 (2023)Cite this article

Subjects

Abstract

Objective

Infants with severe bronchopulmonary dysplasia (sBPD) have complex medical courses. We developed the clinician-rated Optimal State Scoring Tool (OSST) that measures factors relevant to clinical improvement of sBPD and investigated preliminary validity using linear growth outcome and OSST scores in sBPD patients.

Methods

Tool development process and pilot findings are provided for 13 patients evaluated longitudinally. OSST scores, length measurements, and steroid dependency values were obtained. Changes in OSST scores and lengths were examined using linear mixed-effect models.

Results

OSST scores were significantly correlated with linear growth (95% CI 0.36, 0.57). The steroid-dependent group showed significantly slower rate of linear growth (95% CI 0.74, 1.05) and slower rate of increase in OSST scores (95% CI 0.99, 2.13) compared to the non-steroid-dependent group, with the OSST showing the largest effect size.

Conclusion

Pilot data reflect promising evidence for OSST construct validity in monitoring clinical outcomes in sBPD patients.

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Fig. 1: Optimal State Scoring Tool for Severe BPD.
Fig. 2: Phases of BPD (adapted with permission from ref. [7]).
Fig. 3: Length trajectories and OSST total score trajectories.

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Data availability

All data generated or analyzed during this study are included in this published article [and its supplementary information files]. Research data are confidential.

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Acknowledgements

We would like to thank Tara Benninger Ph.D., Emily Bingham RD, Jillane Downs MS, APRN, and Melissa Hanin MOT/L for their support and contributions.

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Authors and Affiliations

  1. Department of Clinical Nutrition & Lactation, Nationwide Children’s Hospital, Columbus, OH, USA

    Jennifer Curtiss

  2. Department of Neonatology, Phoenix Children’s Hospital, Phoenix, AZ, USA

    Pamela Griffiths

  3. Department of Psychology, Nationwide Children’s Hospital, Columbus, OH, USA

    Kevin G. Stephenson & Margaret Mehling

  4. Department of Pharmacy Services, Nationwide Children’s Hospital, Columbus, OH, USA

    Teresa D. Puthoff & Lauren H. Peck

  5. Department of Women’s and Children’s Health, Uppsala Universitet, Uppsala, Sweden

    Fredrik Ahlsson

  6. Department of Pediatrics, Nationwide Children’s Hospital, Columbus, OH, USA

    Roopali Bapat

  7. Department of Neonatology, Nationwide Children’s Hospital, Columbus, OH, USA

    Britany Lendrum-Gatten

  8. NICU, Boston Children’s Hospital, Boston, MA, USA

    Kristen Lindamood

  9. Department of Neonatal Therapy, Nationwide Children’s Hospital, Columbus, OH, USA

    Leah Lumbaca, Kelly Susey & Molly Susi

  10. Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI, USA

    Barbara S. Stonestreet

  11. Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Huayan Zhang

  12. Department of Pediatrics, University of North Carolina System, Chapel Hill, NC, USA

    Susan Lynch

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  1. Jennifer Curtiss
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  14. Molly Susi
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  15. Huayan Zhang
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Contributions

Each author made substantial contributions to conception and design. JC, TP, BLG, LL, MM, LP, KS, MS, and SL collected and contributed to the interpretation of the data. KGS analyzed and interpreted the data and reviewed and revised the final manuscript. JC drafted the initial manuscript and reviewed and revised the final manuscript. PG and TP reviewed and revised the initial draft. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Jennifer Curtiss.

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Curtiss, J., Griffiths, P., Stephenson, K.G. et al. The Optimal State Scoring Tool: guidance for interdisciplinary care of infants with severe bronchopulmonary dysplasia and its relation to linear growth. J Perinatol 43, 1301–1307 (2023). https://doi.org/10.1038/s41372-023-01680-x

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