Development and Validation of a Nomogram for Predicting Bronchopulmonary Dysplasia in Very-Low-Birth-Weight Infants

Abstract

Background: Bronchopulmonary dysplasia is a common pulmonary disease in newborns and is one of the main causes of death. The aim of this study was to build a new simple-to-use nomogram to screen high-risk populations.Methods: In this single-center retrospective study performed from January 2017 to December 2020, we reviewed data on very-low-birth-weight infants whose gestational ages were below 32 weeks. LASSO regression was used to select variables for the risk model. Then, we used multivariable logistic regression to build the prediction model incorporating these selected features. Discrimination was assessed by the C-index, and and calibration of the model was assessed by and calibration curve and the Hosmer-Lemeshow test.Results: The LASSO regression identified gestational age, duration of ventilation and serum NT-proBNP in the 1st week as significant predictors of BPD. The nomogram-illustrated model showed good discrimination and calibration. The C-index was 0.853 (95% CI: 0.851–0.854) in the training set and 0.855 (95% CI: 0.77–0.94) in the validation set. The calibration curve and Hosmer-Lemeshow test results showed good calibration between the predictions of the nomogram and the actual observations.Conclusion: We demonstrated a simple-to-use nomogram for predicting BPD in the early stage. It may help clinicians recognize high-risk populations.

Association Between NT-proBNP and Prolonged Length of Stay in Hospital Among Preterm Infants Born at 28–31 Weeks' Gestation

“…Alicia et al found that serum NT-proBNP levels during 48–72 h of life were associated with NEC ( 20 ). Our previous studies have also found that in Chinese infants, serum NT-proBNP in the first week may be an important predictor of severe ROP and BPD ( 30 , 31 ). Prolonged mechanical ventilation and repeated intubation/extubation are important risk factors for BPD, and we also found serum NT-proBNP level could precisely predicted weaning failure of infants with RDS (ROC-AUC: 0.977; 95% CI: 0.918–0.997; p < 0.001) ( 18 ).…”

“…Therefore, it is important to find other early factors that could be potential to estimate the length of hospitalization. In our previous study, we used NT-proBNP to predict BPD and ventilator weaning ( 30 , 31 ), which may influence the length of stay in hospital of preterm infants. In this study, we further found the relationship between NT-proBNP level and length of hospital stay, and it was meaningful to further explore the early predictors of the length of hospitalization of preterm infants.…”

“…Then, one of the purposes of this study was to find potential indicators for the early prediction of length of hospital stay among preterm infants, so we did not take into account the NT-proBNP level on the 14th day. In addition, our previous research found the role of NT-proBNP levels on the 7th day in predicting BPD and the severity of BPD ( 30 ), so we planned to further explore the relationship between NT-proBNP level on the 7th day and PLS, which might lay a foundation for future studies on the NT-proBNP level on 7th day as an early predictor of length of stay.…”

Development of a Nomogram for Moderate-to-Severe Bronchopulmonary Dysplasia or Death: Role of N-Terminal Pro-brain Natriuretic Peptide as a Biomarker

“…In the past few decades, many predictive models for BPD have been developed using clinical variables, such as GA, BW, sex, IUGR, MV time, and HsPDA ( 25 , 26 ). As expected, smaller GA, male sex, IUGR, MV time in the first week of life and type of respiratory support on the 7th day after birth were important predictors of moderate-to-severe BPD/death, and patients with HsPDA were more likely to develop moderate-to-severe BPD.…”

The Intertemporal Role of Respiratory Support in Improving Neonatal Outcomes: A Narrative Review

“…Some promising relevant studies regarding extubation readiness in preterm infants have already been published [146,147]. As for BPD, most clinical models of the past were reported to be poor to moderate predictors [148]; but new, promising studies with simple-to-use validated nomograms for predicting BPD in the early stage have emerged [149,150]. The integration of new technologies into clinical practice is not something in the distant future but will very soon be part of routine neonatal care.…”