A Patent Ductus Arteriosus Severity Score Predicts Chronic Lung Disease or Death before Discharge

Afif EL-Khuffash, Adam T. James, John David Corcoran, Patrick Dicker, Orla Franklin, Yasser N. Elsayed, Joseph Y. Ting, Arvind Sehgal, Andra Malikiwi, Andrei Harabor, Amuchou S. Soraisham, Patrick J. McNamara

Research output: Contribution to journalArticleResearchpeer-review

Abstract

OBJECTIVES: To test the hypothesis that a patent ductus arteriosus (PDA) severity score (PDAsc) incorporating markers of pulmonary overcirculation and left ventricular (LV) diastolic function can predict chronic lung disease or death before discharge (CLD/death).

STUDY DESIGN: A multicenter prospective observational study was conducted for infants <29 weeks gestation. An echocardiogram was carried out on day 2 to measure PDA diameter and maximum flow velocity, LV output, diastolic flow in the descending aorta and celiac trunk, and variables of LV function using tissue Doppler imaging. Predictors of CLD/death were identified using logistic regression methods. A PDAsc was created and a receiver operating characteristic curve was constructed to assess its ability to predict CLD/death.

RESULTS: We studied 141 infants at a mean (SD) gestation and birthweight of 26 (1.4) weeks and 952 (235) g, respectively. Five variables were identified that were independently associated with CLD/death (gestation at birth, PDA diameter, maximum flow velocity, LV output, and LV a' wave). The PDAsc had a range from 0 (low risk) to 13 (high risk). Infants who developed CLD/death had a higher score than those who did not (7.3 [1.8] vs 3.8 [2.0], P < .001). PDAsc had an area under the curve of 0.92 (95% CI 0.86-0.97, P < .001) for the ability to predict CLD/death. A PDAsc cut-off of 5 has sensitivity and specificity of 92% and 87%, and positive and negative predictive values of 92% and 82%, respectively.

CONCLUSIONS: A PDAsc on day 2 can predict the later occurrence of CLD/death further highlighting the association between PDA significance and morbidity.

Original languageEnglish
Pages (from-to)1354 - 1361
Number of pages6
JournalJournal of Pediatrics
Volume167
Issue number6
DOIs
Publication statusPublished - 1 Dec 2015

Cite this

EL-Khuffash, A., James, A. T., Corcoran, J. D., Dicker, P., Franklin, O., Elsayed, Y. N., ... McNamara, P. J. (2015). A Patent Ductus Arteriosus Severity Score Predicts Chronic Lung Disease or Death before Discharge. Journal of Pediatrics, 167(6), 1354 - 1361. https://doi.org/10.1016/j.jpeds.2015.09.028
EL-Khuffash, Afif ; James, Adam T. ; Corcoran, John David ; Dicker, Patrick ; Franklin, Orla ; Elsayed, Yasser N. ; Ting, Joseph Y. ; Sehgal, Arvind ; Malikiwi, Andra ; Harabor, Andrei ; Soraisham, Amuchou S. ; McNamara, Patrick J. / A Patent Ductus Arteriosus Severity Score Predicts Chronic Lung Disease or Death before Discharge. In: Journal of Pediatrics. 2015 ; Vol. 167, No. 6. pp. 1354 - 1361.
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title = "A Patent Ductus Arteriosus Severity Score Predicts Chronic Lung Disease or Death before Discharge",
abstract = "OBJECTIVES: To test the hypothesis that a patent ductus arteriosus (PDA) severity score (PDAsc) incorporating markers of pulmonary overcirculation and left ventricular (LV) diastolic function can predict chronic lung disease or death before discharge (CLD/death).STUDY DESIGN: A multicenter prospective observational study was conducted for infants <29 weeks gestation. An echocardiogram was carried out on day 2 to measure PDA diameter and maximum flow velocity, LV output, diastolic flow in the descending aorta and celiac trunk, and variables of LV function using tissue Doppler imaging. Predictors of CLD/death were identified using logistic regression methods. A PDAsc was created and a receiver operating characteristic curve was constructed to assess its ability to predict CLD/death.RESULTS: We studied 141 infants at a mean (SD) gestation and birthweight of 26 (1.4) weeks and 952 (235) g, respectively. Five variables were identified that were independently associated with CLD/death (gestation at birth, PDA diameter, maximum flow velocity, LV output, and LV a' wave). The PDAsc had a range from 0 (low risk) to 13 (high risk). Infants who developed CLD/death had a higher score than those who did not (7.3 [1.8] vs 3.8 [2.0], P < .001). PDAsc had an area under the curve of 0.92 (95{\%} CI 0.86-0.97, P < .001) for the ability to predict CLD/death. A PDAsc cut-off of 5 has sensitivity and specificity of 92{\%} and 87{\%}, and positive and negative predictive values of 92{\%} and 82{\%}, respectively.CONCLUSIONS: A PDAsc on day 2 can predict the later occurrence of CLD/death further highlighting the association between PDA significance and morbidity.",
author = "Afif EL-Khuffash and James, {Adam T.} and Corcoran, {John David} and Patrick Dicker and Orla Franklin and Elsayed, {Yasser N.} and Ting, {Joseph Y.} and Arvind Sehgal and Andra Malikiwi and Andrei Harabor and Soraisham, {Amuchou S.} and McNamara, {Patrick J.}",
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EL-Khuffash, A, James, AT, Corcoran, JD, Dicker, P, Franklin, O, Elsayed, YN, Ting, JY, Sehgal, A, Malikiwi, A, Harabor, A, Soraisham, AS & McNamara, PJ 2015, 'A Patent Ductus Arteriosus Severity Score Predicts Chronic Lung Disease or Death before Discharge' Journal of Pediatrics, vol. 167, no. 6, pp. 1354 - 1361. https://doi.org/10.1016/j.jpeds.2015.09.028

A Patent Ductus Arteriosus Severity Score Predicts Chronic Lung Disease or Death before Discharge. / EL-Khuffash, Afif ; James, Adam T. ; Corcoran, John David ; Dicker, Patrick; Franklin, Orla; Elsayed, Yasser N. ; Ting, Joseph Y. ; Sehgal, Arvind; Malikiwi, Andra; Harabor, Andrei ; Soraisham, Amuchou S.; McNamara, Patrick J.

In: Journal of Pediatrics, Vol. 167, No. 6, 01.12.2015, p. 1354 - 1361.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - A Patent Ductus Arteriosus Severity Score Predicts Chronic Lung Disease or Death before Discharge

AU - EL-Khuffash, Afif

AU - James, Adam T.

AU - Corcoran, John David

AU - Dicker, Patrick

AU - Franklin, Orla

AU - Elsayed, Yasser N.

AU - Ting, Joseph Y.

AU - Sehgal, Arvind

AU - Malikiwi, Andra

AU - Harabor, Andrei

AU - Soraisham, Amuchou S.

AU - McNamara, Patrick J.

PY - 2015/12/1

Y1 - 2015/12/1

N2 - OBJECTIVES: To test the hypothesis that a patent ductus arteriosus (PDA) severity score (PDAsc) incorporating markers of pulmonary overcirculation and left ventricular (LV) diastolic function can predict chronic lung disease or death before discharge (CLD/death).STUDY DESIGN: A multicenter prospective observational study was conducted for infants <29 weeks gestation. An echocardiogram was carried out on day 2 to measure PDA diameter and maximum flow velocity, LV output, diastolic flow in the descending aorta and celiac trunk, and variables of LV function using tissue Doppler imaging. Predictors of CLD/death were identified using logistic regression methods. A PDAsc was created and a receiver operating characteristic curve was constructed to assess its ability to predict CLD/death.RESULTS: We studied 141 infants at a mean (SD) gestation and birthweight of 26 (1.4) weeks and 952 (235) g, respectively. Five variables were identified that were independently associated with CLD/death (gestation at birth, PDA diameter, maximum flow velocity, LV output, and LV a' wave). The PDAsc had a range from 0 (low risk) to 13 (high risk). Infants who developed CLD/death had a higher score than those who did not (7.3 [1.8] vs 3.8 [2.0], P < .001). PDAsc had an area under the curve of 0.92 (95% CI 0.86-0.97, P < .001) for the ability to predict CLD/death. A PDAsc cut-off of 5 has sensitivity and specificity of 92% and 87%, and positive and negative predictive values of 92% and 82%, respectively.CONCLUSIONS: A PDAsc on day 2 can predict the later occurrence of CLD/death further highlighting the association between PDA significance and morbidity.

AB - OBJECTIVES: To test the hypothesis that a patent ductus arteriosus (PDA) severity score (PDAsc) incorporating markers of pulmonary overcirculation and left ventricular (LV) diastolic function can predict chronic lung disease or death before discharge (CLD/death).STUDY DESIGN: A multicenter prospective observational study was conducted for infants <29 weeks gestation. An echocardiogram was carried out on day 2 to measure PDA diameter and maximum flow velocity, LV output, diastolic flow in the descending aorta and celiac trunk, and variables of LV function using tissue Doppler imaging. Predictors of CLD/death were identified using logistic regression methods. A PDAsc was created and a receiver operating characteristic curve was constructed to assess its ability to predict CLD/death.RESULTS: We studied 141 infants at a mean (SD) gestation and birthweight of 26 (1.4) weeks and 952 (235) g, respectively. Five variables were identified that were independently associated with CLD/death (gestation at birth, PDA diameter, maximum flow velocity, LV output, and LV a' wave). The PDAsc had a range from 0 (low risk) to 13 (high risk). Infants who developed CLD/death had a higher score than those who did not (7.3 [1.8] vs 3.8 [2.0], P < .001). PDAsc had an area under the curve of 0.92 (95% CI 0.86-0.97, P < .001) for the ability to predict CLD/death. A PDAsc cut-off of 5 has sensitivity and specificity of 92% and 87%, and positive and negative predictive values of 92% and 82%, respectively.CONCLUSIONS: A PDAsc on day 2 can predict the later occurrence of CLD/death further highlighting the association between PDA significance and morbidity.

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U2 - 10.1016/j.jpeds.2015.09.028

DO - 10.1016/j.jpeds.2015.09.028

M3 - Article

VL - 167

SP - 1354

EP - 1361

JO - Journal of Pediatrics

JF - Journal of Pediatrics

SN - 0022-3476

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EL-Khuffash A, James AT, Corcoran JD, Dicker P, Franklin O, Elsayed YN et al. A Patent Ductus Arteriosus Severity Score Predicts Chronic Lung Disease or Death before Discharge. Journal of Pediatrics. 2015 Dec 1;167(6):1354 - 1361. https://doi.org/10.1016/j.jpeds.2015.09.028