A predictive model for patent ductus arteriosus seven days postpartum in preterm infants: an ultrasound-based assessment of ductus arteriosus intimal thickness within 24 h after birth.
| Autor: | Hu XL; Department of Cardiology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China., Zhu TT; Department of Neonatology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China., Wang H; Department of Cardiology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China., Hou C; Department of Cardiology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China., Ni JC; Department of Cardiology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China., Zhang ZF; Department of Cardiology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China., Li XC; Department of Cardiology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China., Peng H; Department of Epidemiology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, China., Li H; Department of Neonatology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China., Sun L; Department of Cardiology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China., Xu QQ; Department of Cardiology, Children's Hospital of Soochow University, Suzhou, Jiangsu, China. |
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| Jazyk: | angličtina |
| Zdroj: | Frontiers in pediatrics [Front Pediatr] 2024 Apr 25; Vol. 12, pp. 1388921. Date of Electronic Publication: 2024 Apr 25 (Print Publication: 2024). |
| DOI: | 10.3389/fped.2024.1388921 |
| Abstrakt: | Objectives: To develop a predictive model for patent ductus arteriosus (PDA) in preterm infants at seven days postpartum. The model employs ultrasound measurements of the ductus arteriosus (DA) intimal thickness (IT) obtained within 24 h after birth. Methods: One hundred and five preterm infants with gestational ages ranging from 27.0 to 36.7 weeks admitted within 24 h following birth were prospectively enrolled. Echocardiographic assessments were performed to measure DA IT within 24 h after birth, and DA status was evaluated through echocardiography on the seventh day postpartum. Potential predictors were considered, including traditional clinical risk factors, M-mode ultrasound parameters, lumen diameter of the DA (LD), and DA flow metrics. A final prediction model was formulated through bidirectional stepwise regression analysis and subsequently subjected to internal validation. The model's discriminative ability, calibration, and clinical applicability were also assessed. Results: The final predictive model included birth weight, application of mechanical ventilation, left ventricular end-diastolic diameter (LVEDd), LD, and the logarithm of IT (logIT). The receiver operating characteristic (ROC) curve for the model, predicated on logIT, exhibited excellent discriminative power with an area under the curve (AUC) of 0.985 (95% CI: 0.966-1.000), sensitivity of 1.000, and specificity of 0.909. Moreover, the model demonstrated robust calibration and goodness-of-fit ( χ 2 value = 0.560, p > 0.05), as well as strong reproducibility (accuracy: 0.935, Kappa: 0.773), as evidenced by 10-fold cross-validation. A decision curve analysis confirmed the model's broad clinical utility. Conclusions: Our study successfully establishes a predictive model for PDA in preterm infants at seven days postpartum, leveraging the measurement of DA IT. This model enables identifying, within the first 24 h of life, infants who are likely to benefit from timely DA closure, thereby informing treatment decisions. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (© 2024 Hu, Zhu, Wang, Hou, Ni, Zhang, Li, Peng, Li, Sun and Xu.) |
| Databáze: | MEDLINE |
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