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

• Type of Material: Article
• Authors: Shilpa Vyas-Read, Emory University; Erica M. Wymore, University of Colorado; Isabella Zaniletti, Children’s Hospital Association; Karna Murthy, Northwestern University; Michael A. Padula, University of Pennsylvania; William E. Truog, University of Missouri; William A. Engle, Indiana University; Rashmin C. Savani, University of Texas Southwestern; Sushmita Yallapragada, University of Texas Southwestern; J. Wells Logan, Ohio State University; Huayan Zhang, Northwestern University; Erik B. Hysinger, Cincinnati Children's Hospital Medical Center; Theresa R. Grover, University of Colorado; Girija Natarajan, Wayne State University; Leif D. Nelin, Ohio State University; Nicolas F. M. Porta, Northwestern University; Karin P. Potoka, University of Pittsburgh; Robert DiGeronimo, University of Washington; Joanne M. Lagatta, Childrens Hospital of Wisconsin
• Language: English
• Date: 2020-01-01
• Publisher: NATURE PUBLISHING GROUP
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s), under exclusive licence to Springer Nature America, Inc. 2019
• Final Published Version (URL): http://dx.doi.org/10.1038/s41372-019-0508-5
• Title of Journal or Parent Work: JOURNAL OF PERINATOLOGY
• Volume: 40
• Issue: 1
• Start Page: 149
• End Page: 156
• Grant/Funding Information: The Children’s Hospitals Neonatal Consortium (501-c3 organization) supported the statistical analyses presented in this manuscript.
• Keywords: ASSOCIATION; CHILDREN; HYPERTENSION; Science & Technology; PRETERM INFANTS; Obstetrics & Gynecology; BIRTH-WEIGHT INFANTS; Life Sciences & Biomedicine; TRACHEOSTOMY PLACEMENT; OUTCOMES; MANAGEMENT; Pediatrics; ADVERSE EVENTS; PULMONARY VASCULAR-DISEASE
• Research Categories: Health Sciences, Obstetrics and Gynecology; Health Sciences, Medicine and Surgery

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.