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A simple chest radiograph score to predict chronic lung disease in prematurely born infants
A Greenough1, V Kavvadia, A H Johnson
1Department of Child Health, King's College Hospital, London, UK.
Insights
A simple scoring system for preterm infant chest radiographs at 28 days effectively predicts long-term oxygen dependency. This method aids in assessing respiratory outcomes for premature infants.
Area of Science:
- Neonatology
- Pediatric Radiology
- Respiratory Medicine
Background:
- Premature infants often experience respiratory complications.
- Predicting oxygen dependency is crucial for managing long-term outcomes in preterm infants.
Purpose of the Study:
- To evaluate a simple scoring system for characterizing preterm infant chest radiographs at 28 days.
- To assess the system's ability to predict oxygen dependency beyond 36 weeks post-conceptional age (PCA).
Main Methods:
- A scoring system assessed chest radiographs of 42 preterm infants (median gestational age 28 weeks) at ~1 month of age.
- The system evaluated fibrosis, cystic elements, and hyperinflation (max score 8).
- Results were compared with two existing scoring systems.
Main Results:
- Significant differences in scores were observed between oxygen-dependent and non-dependent infants at 28 days and 36 weeks PCA (p < 0.001) for all systems.
- Positive predictive values for predicting 36-week PCA oxygen dependency ranged from 67% to 80% for a score of 3 or more.
- Similar receiver operating characteristic curves were obtained across the systems.
Conclusions:
- A simple 3-abnormality scoring system applied to 28-day chest radiographs provides valuable predictive information.
- This scoring system can aid in predicting oxygen dependency in preterm infants.
- The findings support the utility of early chest radiograph assessment for predicting respiratory outcomes.
Abstract:
A simple scoring system has been evaluated with regard to its ability to characterize the pre-term infant's chest radiograph appearance at 28 days and predict oxygen dependency beyond 36 weeks post-conceptional age (PCA). Chest radiographs taken at approximately 1 month of age in 42 infants (median gestational age 28 weeks) were assessed by the scoring system for the presence of fibrosis/interstitial shadows, cystic elements and degree of hyperinflation (maximum score 8). The system's results were then compared with those obtained using two previously published scoring systems. Using all three systems, there were significant differences in the scores of infants who were and were not oxygen dependent at 28 days (p < 0.001) and 36 weeks PCA (p < 0.001). For the three systems, the positive predictive values of a score of 3 or more to predict oxygen dependency at 36 weeks (PCA) were between 67% and 80% and similar receiver operating characteristic curves were obtained. We conclude that scoring only three abnormalities of the 28 day chest radiograph appearance of pre-term infants gives useful predictive information.