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Predicting tracheostomy using ventilator support at 36 and 44 weeks in infants with grade 2 or 3 bronchopulmonary
Jonathan C Levin1, Joshua Ray Tanzer2, Christopher H Schmid3
1Divisions of Newborn and Pulmonary Medicine, Boston Children's Hospital, Boston, MA, USA. Jonathan.Levin@childrens.harvard.edu.
Objective:
To develop and test models to predict the need for tracheostomy using respiratory support in infants with severe bronchopulmonary dysplasia (BPD).
Study Design:
Retrospective cohort study of Grade 2/3 BPD infants from the BPD Collaborative registry. The primary outcome was tracheostomy and/or death prior to hospital discharge. Harmonized models were derived at 36 and 44 weeks post-menstrual age (PMA) using birth data, respiratory support, and medications. A total of 914 infants were included in training and 1375 in validation.
Results:
The training set included 854 infants at 36 weeks PMA and 319 at 44 weeks PMA. Training model performance to predict tracheostomy/death was strong (36wk AUC 0.89, 44wk AUC 0.89) and validated well (36wk AUC 0.86, 44wk AUC 0.85) with good calibration.
Discussion:
Models incorporating birth data, medications, and ventilator support at 36 and 44 weeks PMA predicted the outcome of tracheostomy/death among infants with Grade 2/3 BPD.
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