Neonatology Division, Harbor-UCLA Medical Center, Torrance, California, USA.
Neonatal-Perinatal Medicine Division, CHOC Children's, Orange, California, USA.
Pediatr Pulmonol. 2021 Feb;56(2):409-417. doi: 10.1002/ppul.25172. Epub 2020 Nov 24.
To compare the abilities of bronchopulmonary dysplasia (BPD) definitions to predict hospital charges as a surrogate of disease complexity.
Retrospective study of infants admitted to the neonatal intensive care unit (NICU) less than 32 weeks gestational age. Subjects were classified according to the Canadian Neonatal Network (CNN), the National Institute of Child Health and Human Development (NICHD) (2018), and Jensen BPD definitions as none, mild (1), moderate (2), or severe (3) BPD. Spearman's correlation was performed to evaluate the association of BPD definitions with health economics outcomes.
One hundred and sixty-eight infants were included with mean birth weight of 1197 g and mean gestational age of 28.4 weeks. More infants were classified as no BPD according to CNN definition (79%) in comparison to NICHD 2018 (64.3%) and Jensen (59.5%) definitions. There were fewer infants as the grade of severity increased for all definitions, this was most linear for Jensen definition with Grade 1 present in 25%, Grade 2 in 12.5%, and Grade 3 in 3%. A stronger correlation with NICU length of stay, NICU hospital charges, NICU charges per day, and first year of life hospital charges was detected for Jensen definition (correlation coefficient of 0.58, 0.66, 0.64, 0.67, respectively) in comparison to CNN and NICHD 2018 definitions (p < .0001).
Jensen BPD definition had the strongest correlation with first year health economics outcomes in our study. Validating recent BPD definitions using population-based data is imperative to improve family counseling and enhance the designs of quality improvement initiatives and therapeutic research studies targeting patient-centric outcomes.
比较支气管肺发育不良（BPD）定义预测医院费用的能力，以作为疾病复杂性的替代指标。
对胎龄小于 32 周的新生儿重症监护病房（NICU）收治的婴儿进行回顾性研究。根据加拿大新生儿网络（CNN）、美国国立儿童健康与人类发育研究所（NICHD）（2018 年）和 Jensen BPD 定义，将受试者分为无 BPD、轻度（1）、中度（2）或重度（3）BPD。采用 Spearman 相关分析评估 BPD 定义与健康经济学结果的关系。
共纳入 168 例婴儿，平均出生体重为 1197g，平均胎龄为 28.4 周。与 NICHD 2018 年（64.3%）和 Jensen 定义（59.5%）相比，根据 CNN 定义，更多婴儿被归类为无 BPD（79%）。随着严重程度的增加，所有定义的婴儿数量都减少了，Jensen 定义最具线性，1 级为 25%，2 级为 12.5%，3 级为 3%。与 CNN 和 NICHD 2018 定义相比，Jensen 定义与 NICU 住院时间、NICU 医院费用、NICU 每日费用和婴儿第一年的生命医院费用具有更强的相关性（相关系数分别为 0.58、0.66、0.64、0.67）（p < 0.0001）。
在本研究中，Jensen BPD 定义与第一年的健康经济学结果相关性最强。使用基于人群的数据验证最近的 BPD 定义对于改善家庭咨询以及增强以患者为中心的结果为目标的质量改进举措和治疗研究设计至关重要。
