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一种用于预测早产儿支气管肺发育不良风险的列线图。

A nomogram for predicting the risk of Bronchopulmonary dysplasia in premature infants.

作者信息

Shen Xian, Patel Nishant, Zhu Wen, Chen Xu, Lu Keyu, Cheng Rui, Mo Xuming

机构信息

Department of Neonatology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China.

Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China.

出版信息

Heliyon. 2023 Aug 9;9(8):e18964. doi: 10.1016/j.heliyon.2023.e18964. eCollection 2023 Aug.

Abstract

BACKGROUND

Bronchopulmonary dysplasia (BPD) is a prevalent and critical complication among premature infants, with potentially long-lasting adverse effetcs. The present study aimed to establish a nomogram model to predict the risk of BPD in premature infants born at <32 weeks gestational age.

METHODS

A retrospective single-center study was conducted on premature infants admitted to the neonatal intensive care unit (NICU) of the Children's Hospital of Nanjing Medical University from January 2018 to December 2020. Data were collected from clinical medical records, including the perinatal data and the critical information after birth. Clinical parameters and features were analyzed using univariate and multivariate logistic regression. A nomogram based on clinical data was established and validated using bootstrapping samples. The specificity and sensitivity of the nomogram were estimated using the receiver operating characteristic (ROC) based area under the curve (AUC).

RESULTS

A total of 542 premature babies were included, and 152 infants (28.04%) were diagnosed with BPD. Birth weight, cesarean delivery, invasive/non-invasive ventilation at day 7 and 14 were identified as significant factors ( < 0.05) using univariate and the multivariate logistic regression analysis, and were entered into a nomogram. The calibration curve for BPD probability demonstrated a favorable concurrence between actual probability and predicted ability of the BPD nomogram. The nomogram showed potential differentiation, with an AUC of 0.925, 89.90% sensitivity, 76.71% specificity, and 86.35% accuracy.

CONCLUSION

The nomogram developed in this study provides a straightforward tool to predict the probability of BPD and assist clinicians in optimizing treatment regimens for premature infants born at <32 weeks gestational age. This study highlights the importance of identifying and monitoring significant clinical factors associated with BPD in premature infants to improve clinical outcomes.

摘要

背景

支气管肺发育不良(BPD)是早产儿中常见且严重的并发症,可能产生长期不良影响。本研究旨在建立一个列线图模型,以预测孕周<32周的早产儿发生BPD的风险。

方法

对2018年1月至2020年12月在南京医科大学附属儿童医院新生儿重症监护病房(NICU)收治的早产儿进行回顾性单中心研究。从临床病历中收集数据,包括围产期数据和出生后的关键信息。采用单因素和多因素逻辑回归分析临床参数和特征。基于临床数据建立列线图,并使用自助抽样样本进行验证。使用基于受试者工作特征(ROC)曲线下面积(AUC)来估计列线图的特异性和敏感性。

结果

共纳入542例早产儿,其中152例(28.04%)被诊断为BPD。通过单因素和多因素逻辑回归分析,出生体重、剖宫产、出生后第7天和第14天的有创/无创通气被确定为显著因素(P<0.05),并纳入列线图。BPD概率的校准曲线显示实际概率与BPD列线图的预测能力之间具有良好的一致性。列线图显示出潜在的区分能力,AUC为0.925,敏感性为89.90%,特异性为76.71%,准确性为86.35%。

结论

本研究开发的列线图提供了一个直接的工具来预测BPD的概率,并帮助临床医生优化孕周<32周早产儿的治疗方案。本研究强调了识别和监测与早产儿BPD相关的重要临床因素以改善临床结局的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bc8/10440517/0621f775525f/gr1.jpg

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