Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
Neonatal Intensive Care Centre, King's College Hospital NHS Foundation Trust, London, UK.
J Perinat Med. 2021 Dec 1;50(3):327-333. doi: 10.1515/jpm-2021-0366. Print 2022 Mar 28.
Pulmonary hypertension (PH) is a complication of bronchopulmonary dysplasia (BPD) and associated with increased mortality and morbidity. Our aim was to identify, in infants with BPD, the effect of PH on health-care utilisation and health related cost of care.
An electronic data recording system was used to identify infants ≤32 weeks of gestation who developed BPD. PH was classified as early (≤28 days after birth) or late (>28 days after birth).
In the study period, 182 infants developed BPD; 22 (12.1%) developed late PH. Development of late PH was associated with a lower gestational age [24.6 (23.9-26.9) weeks, p=0.001] and a greater need for positive pressure ventilation on day 28 after birth (100%) compared to infants without late PH (51.9%) (odds ratio (OR) 19.5, 95% CI: 2.6-148), p<0.001. Late PH was associated with increased mortality (36.4%) compared those who did not develop late PH (1.9%) after adjusting for gestational age and ventilation duration (OR: 26.9, 95% CI: 3.8-189.4), p<0.001. In infants who survived to discharge, late PH development was associated with a prolonged duration of stay [147 (118-189) days] compared to the infants that did not develop late PH [109 (85-149) days] (p=0.03 after adjusting for gestational age). Infants who had late PH had a higher cost of stay compared to infants with BPD who did not develop late PH (median £113,494 vs. £78,677, p=0.016 after adjusting for gestational age).
Development of late PH was associated with increased mortality, a prolonged duration of stay and higher healthcare cost.
肺动脉高压（PH）是支气管肺发育不良（BPD）的并发症，与死亡率和发病率增加有关。我们的目的是在患有 BPD 的婴儿中确定 PH 对医疗保健利用和相关护理成本的影响。
使用电子数据记录系统来识别胎龄≤32 周的发生 BPD 的婴儿。PH 分为早期（出生后≤28 天）或晚期（出生后>28 天）。
在研究期间，182 名婴儿发生 BPD；22 名（12.1%）发生晚期 PH。与未发生晚期 PH 的婴儿相比，晚期 PH 的发生与较低的胎龄[24.6（23.9-26.9）周，p=0.001]和出生后 28 天需要更高的正压通气（100%）有关[与未发生晚期 PH 的婴儿相比，51.9%（优势比（OR）19.5，95%CI：2.6-148），p<0.001]。在调整胎龄和通气持续时间后，晚期 PH 与死亡率增加相关（36.4%），而未发生晚期 PH 的婴儿为 1.9%（OR：26.9，95%CI：3.8-189.4），p<0.001。在存活至出院的婴儿中，与未发生晚期 PH 的婴儿相比，晚期 PH 的发生与住院时间延长有关[147（118-189）天]，而未发生晚期 PH 的婴儿为[109（85-149）天]（p=0.03，在调整胎龄后）。与未发生晚期 PH 的 BPD 婴儿相比，发生晚期 PH 的婴儿的住院费用更高（中位数为 113494 英镑 vs. 78677 英镑，p=0.016，在调整胎龄后）。
晚期 PH 的发生与死亡率增加、住院时间延长和医疗保健费用增加有关。
