Mortality among infants with evolving bronchopulmonary dysplasia increases with major surgery and with pulmonary hypertension

Objective: To assess whether mortality in patients with evolving bronchopulmonary dysplasia (BPD, defined as ⩾28 days of oxygen exposure with lung disease) is independently associated with pulmonary arterial hypertension (PAH) and surgery. Study Design: Single institution retrospective birth cohort...

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Bibliographic Details
Published in:Journal of perinatology 2017-09, Vol.37 (9), p.1043-1046
Main Authors: DeVries, L B, Heyne, R J, Ramaciotti, C, Brown, L S, Jaleel, M A, Kapadia, V S, Burchfield, P J, Brion, L P
Format: Article
Language:English
Subjects:
692/308/409
692/699/75/593/1920
Birth weight
Bronchopulmonary dysplasia
Bronchopulmonary Dysplasia - mortality
Bronchopulmonary Dysplasia - surgery
Case-Control Studies
Complications and side effects
Confidence intervals
Demographic aspects
Dysplasia
Electrocardiography
Evolution
Female
Gestational Age
Health aspects
Health risk assessment
Humans
Hypertension
Hypertension, Pulmonary - diagnosis
Hypertension, Pulmonary - mortality
Infant
Infant mortality
Infant, Extremely Premature
Infant, Newborn
Infants
Intensive Care Units, Neonatal - statistics & numerical data
Logistic Models
Lung diseases
Male
Medicine
Medicine & Public Health
Mortality
original-article
Patients
Pediatric Surgery
Pediatrics
Prognosis
Pulmonary hypertension
Regression analysis
Retrospective Studies
Risk Factors
Statistical analysis
Surgery
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Summary:Objective: To assess whether mortality in patients with evolving bronchopulmonary dysplasia (BPD, defined as ⩾28 days of oxygen exposure with lung disease) is independently associated with pulmonary arterial hypertension (PAH) and surgery. Study Design: Single institution retrospective birth cohort of preterm infants with gestational age (GA) 23 0/7 to 36 6/7 weeks, and evolving BPD delivered between 2001 and 2014. Surgery was classified as minor or major using published criteria. Mortality was analyzed by stepwise logistic regression analysis. Results: Among 577 patients with evolving BPD, 33 (6%) died prior to discharge. Mortality decreased with GA (adjusted odds ratio (aOR): 0.69; 95% confidence interval (CI): 0.55, 0.87), birth weight Z -score (aOR: 0.69, 95% CI: 0.47, 0.996) and increased with PAH (aOR: 30, 95% CI: 2.1, 415), major surgery (aOR; 2.8, 95% CI: 1.3, 6.3), and PAH and surgery (aOR: 10.3, 95% CI: 2.5, 42.1). Conclusion: Among preterm patients with evolving BPD, PAH and surgery are independently associated with mortality.
ISSN:0743-8346
1476-5543
DOI:10.1038/jp.2017.89