Utility of echocardiography in predicting mortality in infants with severe bronchopulmonary dysplasia

on behalf of the Children’s Hospitals Neonatal Consortium Severe BPD Focus Group

Research output: Contribution to journalArticle

Abstract

Objective: To determine the relationship between interventricular septal position (SP) and right ventricular systolic pressure (RVSP) and mortality in infants with severe BPD (sBPD). Study design: Infants with sBPD in the Children’s Hospitals Neonatal Database who had echocardiograms 34–44 weeks’ postmenstrual age (PMA) were included. SP and RVSP were categorized normal, abnormal (flattened/bowed SP or RVSP > 40 mmHg) or missing. Results: Of 1157 infants, 115 infants (10%) died. Abnormal SP or RVSP increased mortality (SP 19% vs. 8% normal/missing, RVSP 20% vs. 9% normal/missing, both p < 0.01) in unadjusted and multivariable models, adjusted for significant covariates (SP OR 1.9, 95% CI 1.2–3.0; RVSP OR 2.2, 95% CI 1.1–4.7). Abnormal parameters had high specificity (SP 82%; RVSP 94%), and negative predictive value (SP 94%, NPV 91%) for mortality. Conclusions: Abnormal SP or RVSP is independently associated with mortality in sBPD infants. Negative predictive values distinguish infants most likely to survive.

Original languageEnglish (US)
JournalJournal of Perinatology
DOIs
StateAccepted/In press - Jan 1 2019

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Bronchopulmonary Dysplasia
Infant Mortality
Ventricular Pressure
Echocardiography
Blood Pressure
Mortality
Databases

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Utility of echocardiography in predicting mortality in infants with severe bronchopulmonary dysplasia. / on behalf of the Children’s Hospitals Neonatal Consortium Severe BPD Focus Group.

In: Journal of Perinatology, 01.01.2019.

Research output: Contribution to journalArticle

on behalf of the Children’s Hospitals Neonatal Consortium Severe BPD Focus Group. / Utility of echocardiography in predicting mortality in infants with severe bronchopulmonary dysplasia. In: Journal of Perinatology. 2019.
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abstract = "Objective: To determine the relationship between interventricular septal position (SP) and right ventricular systolic pressure (RVSP) and mortality in infants with severe BPD (sBPD). Study design: Infants with sBPD in the Children’s Hospitals Neonatal Database who had echocardiograms 34–44 weeks’ postmenstrual age (PMA) were included. SP and RVSP were categorized normal, abnormal (flattened/bowed SP or RVSP > 40 mmHg) or missing. Results: Of 1157 infants, 115 infants (10{\%}) died. Abnormal SP or RVSP increased mortality (SP 19{\%} vs. 8{\%} normal/missing, RVSP 20{\%} vs. 9{\%} normal/missing, both p < 0.01) in unadjusted and multivariable models, adjusted for significant covariates (SP OR 1.9, 95{\%} CI 1.2–3.0; RVSP OR 2.2, 95{\%} CI 1.1–4.7). Abnormal parameters had high specificity (SP 82{\%}; RVSP 94{\%}), and negative predictive value (SP 94{\%}, NPV 91{\%}) for mortality. Conclusions: Abnormal SP or RVSP is independently associated with mortality in sBPD infants. Negative predictive values distinguish infants most likely to survive.",
author = "{on behalf of the Children’s Hospitals Neonatal Consortium Severe BPD Focus Group} and Shilpa Vyas-Read and Wymore, {Erica M.} and Isabella Zaniletti and Karna Murthy and Padula, {Michael A.} and Truog, {William E.} and Engle, {William A.} and Savani, {Rashmin C.} and Sushmita Yallapragada and Logan, {J. Wells} and Huayan Zhang and Hysinger, {Erik B.} and Grover, {Theresa R.} and Girija Natarajan and Nelin, {Leif D.} and Porta, {Nicolas F.M.} and Potoka, {Karin P.} and Robert DiGeronimo and Lagatta, {Joanne M.}",
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AU - on behalf of the Children’s Hospitals Neonatal Consortium Severe BPD Focus Group

AU - Vyas-Read, Shilpa

AU - Wymore, Erica M.

AU - Zaniletti, Isabella

AU - Murthy, Karna

AU - Padula, Michael A.

AU - Truog, William E.

AU - Engle, William A.

AU - Savani, Rashmin C.

AU - Yallapragada, Sushmita

AU - Logan, J. Wells

AU - Zhang, Huayan

AU - Hysinger, Erik B.

AU - Grover, Theresa R.

AU - Natarajan, Girija

AU - Nelin, Leif D.

AU - Porta, Nicolas F.M.

AU - Potoka, Karin P.

AU - DiGeronimo, Robert

AU - Lagatta, Joanne M.

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N2 - Objective: To determine the relationship between interventricular septal position (SP) and right ventricular systolic pressure (RVSP) and mortality in infants with severe BPD (sBPD). Study design: Infants with sBPD in the Children’s Hospitals Neonatal Database who had echocardiograms 34–44 weeks’ postmenstrual age (PMA) were included. SP and RVSP were categorized normal, abnormal (flattened/bowed SP or RVSP > 40 mmHg) or missing. Results: Of 1157 infants, 115 infants (10%) died. Abnormal SP or RVSP increased mortality (SP 19% vs. 8% normal/missing, RVSP 20% vs. 9% normal/missing, both p < 0.01) in unadjusted and multivariable models, adjusted for significant covariates (SP OR 1.9, 95% CI 1.2–3.0; RVSP OR 2.2, 95% CI 1.1–4.7). Abnormal parameters had high specificity (SP 82%; RVSP 94%), and negative predictive value (SP 94%, NPV 91%) for mortality. Conclusions: Abnormal SP or RVSP is independently associated with mortality in sBPD infants. Negative predictive values distinguish infants most likely to survive.

AB - Objective: To determine the relationship between interventricular septal position (SP) and right ventricular systolic pressure (RVSP) and mortality in infants with severe BPD (sBPD). Study design: Infants with sBPD in the Children’s Hospitals Neonatal Database who had echocardiograms 34–44 weeks’ postmenstrual age (PMA) were included. SP and RVSP were categorized normal, abnormal (flattened/bowed SP or RVSP > 40 mmHg) or missing. Results: Of 1157 infants, 115 infants (10%) died. Abnormal SP or RVSP increased mortality (SP 19% vs. 8% normal/missing, RVSP 20% vs. 9% normal/missing, both p < 0.01) in unadjusted and multivariable models, adjusted for significant covariates (SP OR 1.9, 95% CI 1.2–3.0; RVSP OR 2.2, 95% CI 1.1–4.7). Abnormal parameters had high specificity (SP 82%; RVSP 94%), and negative predictive value (SP 94%, NPV 91%) for mortality. Conclusions: Abnormal SP or RVSP is independently associated with mortality in sBPD infants. Negative predictive values distinguish infants most likely to survive.

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