Mortality among infants with evolving bronchopulmonary dysplasia increases with major surgery and with pulmonary hypertension

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Abstract

OBJECTIVE:

To assess whether mortality in patients with evolving bronchopulmonary dysplasia (BPD, defined as ≥ 28 days of oxygen exposure with lung disease) is independently associated with pulmonary arterial hypertension (PAH) and surgery.

STUDY DESIGN:

Single institution retrospective birth cohort of preterm infants with gestational age (GA) 230/7 to 366/7 weeks, and evolving BPD delivered between 2001 and 2014. Surgery was classified as minor or major using published criteria. Mortality was analyzed by stepwise logistic regression analysis.

RESULTS:

Among 577 patients with evolving BPD, 33 (6%) died prior to discharge. Mortality decreased with GA (adjusted odds ratio (aOR): 0.69; 95% confidence interval (CI): 0.55, 0.87), birth weight Z-score (aOR: 0.69, 95% CI: 0.47, 0.996) and increased with PAH (aOR: 30, 95% CI: 2.1, 415), major surgery (aOR; 2.8, 95% CI: 1.3, 6.3), and PAH and surgery (aOR: 10.3, 95% CI: 2.5, 42.1).

CONCLUSION:

Among preterm patients with evolving BPD, PAH and surgery are independently associated with mortality.

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