Variables related to bronchopulmonary dysplasia severity: a Six-Year retrospective study

Abstract

Objectives

This was a retrospective observational study conducted in a tertiary neonatal intensive care unit, in order to investigate factors which influenced the severity of bronchopulmonary dysplasia under NICHD new classification.

Methods

Six years of clinical data with different grades of bronchopulmonary dysplasia patients were collected and analyzed, bivariate ordinal logistic regression model and multivariable ordinal logistic regression model were used with sensitivity analyses.

Results

We identified seven variables were associated with the severity of BPD via a bivariate ordinal logistic regression model, including the level of referral hospital (OR 0.273；95% CI 0.117, 0.636), method of caffeine administration (OR 00.418；95% CI 0.177, 0.991), more than two occurrences of reintubation (OR 4.925；95% CI 1.878, 12.915), CPAP reapplication (OR 2.255；95% CI 1.059, 4.802), presence of positive sputum cultures (OR 2.574；95% CI 1.200, 5.519), the cumulative duration of invasive ventilation (OR 1.047；95% CI 1.017, 1.078), and postmenstrual age at the discontinuation of oxygen supplementation (OR 1.190；95% CI 1.027, 1.38). These seven variables were further analyzed via all multivariable ordinal logistic regression models, and we found that tertiary hospital birth and early administration of caffeine could reduce the severity of BPD by approximately 70% (OR 0.263；95% CI 0.090, 0.770) and 60% (OR 0.371；95% CI 0.138, 0.995), respectively. In contrast, multiple reintubations were related to higher BPD severity with an OR of 3.358 (95% CI 1.002, 11.252).

Conclusion

Improving perinatal care in level II hospitals, standardized caffeine administration, and optimized extubation strategy could potentially decrease the severity of BPD.

Keywords:

• Bronchopulmonary dysplasia
• reintubation
• caffeine
• influencing factor
• tertiary hospital

Disclosure statement

The authors declare that they have no conflict of interest.

Data availability statement

All data included in this study are available upon request by contact with the corresponding author.

Additional information

Funding

This work was supported by the Natural Science Foundation Committee of Shandong Province under Natural Science Foundation of Shandong Province (ZR2019PH019)

Notes on contributors

Beibei Yan

BBY: Contributed to conception and design; contributed to acquisition, analysis, and interpretation; drafted the manuscript; critically revised the manuscript; gave final approval; agrees to be accountable for all aspects of work ensuring integrity and accuracy.

Yunxia Li

YXL: Contributed acquisition, analysis, and interpretation; gave final approval; agrees to be accountable for all aspects of work ensuring integrity and accuracy.

Mingying Sun

MYS: Contributed to acquisition, analysis, and interpretation; gave final approval; agrees to be accountable for all aspects of work ensuring integrity and accuracy.

Yan Meng

YM: Contributed to acquisition, analysis, and interpretation; gave final approval; agrees to be accountable for all aspects of work ensuring integrity and accuracy.

Xiaoying Li

XYL: Contributed to conception and design; critically revised the manuscript; gave final approval; agrees to be accountable for all aspects of work ensuring integrity and accuracy.