Risk Prediction of Severe Bronchopulmonary Dysplasia (BPD) Using the Respiratory Severity Score (RSS) in Extremely
Eslam M Abuelsaeed1, Ahmed M Helal1, Abdulrahman A Almehery1
1Neonatal Intensive Care Unit, Armed Forces Hospital Southern Region (AFHSR), Khamis Mushait, SAU.
Insights
The Respiratory Severity Score (RSS) can predict severe bronchopulmonary dysplasia (BPD) or death in very preterm infants. Higher RSS values on days 14, 21, and 28 indicate an increased risk, aiding early diagnosis and treatment planning for BPD.
Area of Science:
- Neonatology
- Pediatric Pulmonology
Background:
- Bronchopulmonary dysplasia (BPD) is a serious complication in extremely preterm infants.
- Early diagnosis of BPD is crucial for effective treatment strategies.
Purpose of the Study:
- To evaluate the predictive accuracy of the Respiratory Severity Score (RSS) for severe BPD or mortality in very preterm infants.
Main Methods:
- Retrospective study of preterm infants (gestational age ≤30 weeks) requiring mechanical ventilation.
- RSS values were collected on postnatal days 3, 14, 21, and 28.
- Multivariate logistic regression analyzed the correlation between RSS and outcomes.
Main Results:
- 154 infants were analyzed; 53.24% developed severe BPD, and 24.67% died.
- Higher RSS was observed in infants with severe BPD or mortality.
- RSS on days 14, 21, and 28 significantly predicted increased risk of death or severe BPD.
Conclusions:
- The Respiratory Severity Score (RSS) demonstrates predictive value for severe BPD in very preterm infants.
- RSS can assist clinicians in identifying high-risk infants for timely intervention.
Abstract:
Background Bronchopulmonary dysplasia (BPD) is a significant complication in extremely preterm infants. Therefore, early diagnosis of BPD is important for planning treatment strategies. In this study, we aimed to assess the predictive efficacy of the Respiratory Severity Score (RSS) in determining severe BPD or death outcomes in very preterm infants. Methodology This retrospective study included preterm infants born with a gestational age of ≤30 weeks. The inclusion criteria comprised individuals who were mechanically ventilated (<1 week) during the first four weeks of life. Any patients who died during the first seven days of life were excluded. RSS values were recorded on days 3, 14, 21, and 28 of life. Multivariate logistic regression was used to identify a correlation between RSS and patient outcomes. Results A total of 154 infants were included in the analysis, of whom 82 (53.24%) developed severe BPD and 38 (24.67%) died. RSS was higher in patients who either died or developed severe BPD compared to those who survived. The multivariate logistic regression analysis revealed that RSSs at postnatal day 14 (odds ratio (OR) = 3.970; 95% confidence interval (CI) = 1.114-14.147; p < 0.05), day 21 (OR = 6.201; 95% CI = 1.937-19.851; p < 0.05), and day 28 (OR = 8.925; 95% CI = 3.331-28.383; p < 0.05) was significantly associated with a higher risk of death or severe BPD. Conclusions The findings of the present study revealed that RSS can help predict the risk of severe BPD in very preterm infants.
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