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

Vyas-Read, S.; Wymore, E. M.; Zaniletti, I.; Murthy, K.; Padula, M. A.; Truog, W. E.; Engle, W. A.; Savani, R. C.; Yallapragada, S.; Logan, J. W.; Zhang, H.; Hysinger, E. B.; Grover, T. R.; Natarajan, G.; Nelin, L. D.; Porta, N. F. M.; Potoka, K. P.; DiGeronimo, R.; Lagatta, J. M.

J Perinatol. 2019 Oct 2; 40(1):149-156

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.

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