Risk Factors and Clinical Outcomes in Preterm Infants with Pulmonary Hypertension.
Risk Factors and Clinical Outcomes in Preterm Infants with Pulmonary Hypertension.
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DOI：
10.1371/journal.pone.0163904
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
McGrath-Morrow SA
中科院分区：
文献类型：
--
作者：
Collaco JM;Dadlani GH;Nies MK;Leshko J;Everett AD;McGrath-Morrow SA
肺动脉高压（PH）是早产儿发病的重要原因，但没有筛查指南。我们试图识别与早产儿PH相关的风险因素和临床结局，以制定PH风险评分。回顾性分析两个独立的早产儿人群（NICU队列n = 230;临床登记n = 580）。8.3%的NICU队列在4周龄后患有PH，而14.8%的临床登记在2个月后患有PH。在两个人群中，出生体重较低和初始住院时间较长与PH相关（所有测试p<0.001）。使用校正的逻辑回归，在NICU队列（OR：3.19; p = 0.024）和临床登记研究（OR：2.67; p<0.001）中，需要结扎的动脉导管未闭（PDA）与PH相关。在NICU队列中验证了临床登记研究（训练数据集）中确定的风险因素（出生体重≤780 g、家庭辅助供氧和PDA结扎），其中0-1个因素与PH发生概率≤1.5%相关，任何2个因素与PH发生概率25%相关，所有3个因素与PH发生概率40%相关。低出生体重、PDA结扎和呼吸支持与两个人群中的PH相关。基于来自训练数据集的临床指标的PH风险评分预测了验证集中的PH。该风险评分有助于将资源集中于PH风险较高的早产儿。需要进一步研究以确定早期或更积极的导管病变治疗是否会改变PH结局。
Pulmonary hypertension (PH) is a significant cause of morbidity in preterm infants, but no screening guidelines exist. We sought to identify risk factors and clinical outcomes associated with PH in preterm infants to develop a PH risk score. Retrospective analysis of two separate populations of preterm infants (NICU cohort n = 230; Clinic registry n = 580). 8.3% of the NICU cohort had PH after 4 weeks of age, while 14.8% of the clinic registry had PH after 2 months of age. Lower birth weights and longer initial hospitalizations were associated with PH in both populations (p<0.001 for all tests). Using adjusted logistic regression, patent ductus arteriosus (PDA) requiring ligation was associated with PH in both the NICU cohort (OR: 3.19; p = 0.024) and the clinic registry (OR: 2.67; p<0.001). Risk factors (birth weight ≤780 grams, home supplemental oxygen use, and PDA ligation) identified in the clinic registry (training dataset) were validated in the NICU cohort with 0–1 factors present were associated with ≤1.5% probability of having PH, any 2 factors with a 25% probability, and all 3 factors with a 40% probability. Lower birth weight, PDA ligation, and respiratory support were associated with PH in both populations. A PH risk score based on clinical indicators from the training dataset predicted PH in the validation set. This risk score could help focus resources to preterm infants at higher risk for PH. Further work is needed to determine whether earlier or more aggressive management of ductal lesions could alter PH outcomes.
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影响因子：
3.8
作者：
Mestan, K. K.;Check, J.;Ernst, L. M.
通讯作者：
Ernst, L. M.
胎儿生长限制和支气管肺发育不良的早产儿的肺部高血压。
影响因子：
2.9
作者：
Check, J.;Gotteiner, N.;Liu, X.;Su, E.;Porta, N.;Steinhorn, R.;Mestan, K. K.
通讯作者：
Mestan, K. K.
影响因子：
2.5
作者：
Kim, Do-Hyun;Kim, Han-Suk;Choi, Jung-Hwan
通讯作者：
Choi, Jung-Hwan
影响因子：
0.9
作者：
Dereddy, Narendra R.;Chilakala, Sandeep R.;Rana, Divya
通讯作者：
Rana, Divya
DOI：
10.1111/apa.12717
发表时间：
2014-10
期刊：
Acta paediatrica (Oslo, Norway : 1992)
影响因子：
--
作者：
Trittmann JK;Nelin LD;Zmuda EJ;Gastier-Foster JM;Chen B;Backes CH;Frick J;Vaynshtok P;Vieland VJ;Klebanoff MA
通讯作者：
Klebanoff MA