Tale of Two Patent Ductus Arteriosus Severity Scores: Similarities and Differences

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Several echocardiographic scoring systems have been developed to assess the severity of patent ductus arteriosus (PDA) shunting in preterm infants.


The objective of this study was to compare the ability of two different scoring systems to evaluate the hemodynamic significance of the PDA and to predict long-term PDA-associated morbidities.


El-Khuffash cohort (previously described) was derived from a multicenter, prospective, observational study conducted in tertiary neonatal intensive care units in Ireland, Canada, and Australia.


A total of 141 infants with a mean gestational age of 26 ± 1.4 weeks and a mean birth weight of 952 ± 235 g were evaluated on day 2 of life. The two scores were well correlated with each other and both scores positively predicted chronic lung disease/death in this population.


There appears to be an overall stepwise progression in the incidence of poor outcome parameters from “closed” to “borderline” to “hemodynamically significant” PDA. Both the El-Khuffash and Shaare Zedek scores are predictive of PDA-associated morbidities.

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