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Infants with chronic lung disease: predictors of mortality at day 28
Insights
A study of 242 infants with chronic lung disease found that male infants and those requiring more ventilatory support or higher oxygen concentrations had a higher risk of in-hospital death. A predictive equation was developed for infant mortality risk.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Clinical Epidemiology
Background:
- Chronic lung disease (CLD) is a significant concern for infants in the neonatal intensive care unit (NICU).
- Understanding predictors of mortality and morbidity in CLD infants is crucial for clinical management and resource allocation.
Purpose of the Study:
- To determine the outcome of infants with CLD admitted to the NICU.
- To identify factors associated with in-hospital mortality in these infants.
- To develop and validate a predictive equation for mortality risk.
Main Methods:
- Retrospective analysis of 242 infants with CLD admitted to Liverpool Maternity Hospital (1980-1989).
- Statistical analysis including logistic regression to identify independent predictors of death.
- Validation of a derived mortality prediction equation at a separate center (Nottingham).
Main Results:
- 18% of infants with CLD died in the hospital; 9% of survivors required home oxygen therapy.
- Increased days of ventilatory support and higher inspired oxygen concentration on day 28 correlated with mortality.
- Male sex was independently associated with in-hospital death.
Conclusions:
- A validated equation can predict the probability of death in infants with CLD.
- This predictive tool may aid clinical decision-making and future research in neonatal chronic lung disease.
- Identifying high-risk infants can inform targeted interventions and improve outcomes.
Abstract:
The outcome of infants who were admitted to the neonatal intensive care unit at Liverpool Maternity Hospital between January 1980 and December 1989 and who developed chronic lung disease (n = 242) was determined. Forty-three (18%) died in hospital and 18 (9% of survivors) were discharged with home oxygen therapy. The number of days spent receiving supplementary oxygen significantly correlated with the number of days of ventilatory support received and the inspired oxygen concentration on day 28. Logistic regression analysis revealed that death in the hospital was independently associated with being male, and correlated with the number of days of ventilatory support received and the inspired oxygen concentration on day 28. An equation that predicted the probability of death in infants with chronic lung disease was derived and was validated for infants with chronic lung disease at another center (Nottingham). This equation may be useful clinically and for research.