患有进展性支气管肺发育不良的婴儿死亡率会随着大手术和肺动脉高压而增加。
Mortality among infants with evolving bronchopulmonary dysplasia increases with major surgery and with pulmonary hypertension.
作者信息
DeVries L B, Heyne R J, Ramaciotti C, Brown L S, Jaleel M A, Kapadia V S, Burchfield P J, Brion L P
机构信息
Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Division of Cardiology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
出版信息
J Perinatol. 2017 Sep;37(9):1043-1046. doi: 10.1038/jp.2017.89. Epub 2017 Jun 15.
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 to 36 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.
目的
评估进展性支气管肺发育不良（BPD，定义为因肺部疾病接受氧气治疗≥28天）患者的死亡率是否与肺动脉高压（PAH）及手术独立相关。
研究设计
对2001年至2014年间出生的胎龄（GA）为23至36周且患有进展性BPD的早产儿进行单机构回顾性队列研究。根据已发表的标准将手术分为小手术或大手术。通过逐步逻辑回归分析对死亡率进行分析。
结果
在577例患有进展性BPD的患者中，33例（6%）在出院前死亡。死亡率随胎龄降低（调整优势比（aOR）：0.69；95%置信区间（CI）：0.55，0.87）、出生体重Z评分降低（aOR：0.69，95%CI：0.47，0.996）而降低，随PAH升高（aOR：30, 95%CI：2.1, 415）、大手术（aOR；2.8, 95%CI：1.3, 6.3）以及PAH合并手术（aOR：10.3, 95%CI：2.5, 42.1）而升高。
结论
在患有进展性BPD的早产儿中，PAH及手术与死亡率独立相关。
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