Mortality in Outpatients with Bronchopulmonary Dysplasia

Objectives To study the demographic and clinical characteristics of preterm infants with bronchopulmonary dysplasia (BPD) to identify the factors most strongly predictive of outpatient mortality, with the goal of identifying those individuals at greatest risk. Study design Demographic and clinical characteristics were retrospectively reviewed for 862 subjects recruited from an outpatient BPD clinic. Characteristics of the deceased and living participants were compared using nonparametric analysis. Regression analysis was performed to identify factors associated with mortality. Results Of the 862 subjects, 13 (1.5%) died during follow-up, for an overall mortality rate of approximately 15.1 deaths per 1000 subjects. Two patients died in the postneonatal period (annual mortality incidence, 369.9 per 100 000), 9 died between age 1 and 4 years (annual mortality incidence, 310.2 per 100 000), and 2 died between age of 5 and 14 years (annual mortality incidence, 71.4 per 100 000). After adjusting for gestational age and BPD severity, mortality was found to be associated with the amount of supplemental oxygen required at discharge from the neonatal intensive care unit (adjusted hazard ratio [aHR], 4.10; P =.001), presence of a gastrostomy tube (aHR, 8.13; P =.012), and presence of a cerebrospinal fluid (CSF) shunt (aHR, 4.31; P =.021). Conclusions The incidence of mortality among preterm infants with BPD is substantially higher than that seen in the general population. The need for greater amounts of home supplemental oxygen and the presence of a gastrostomy tube or CSF shunt were associated with an increased risk of postdischarge mortality. Future studies should focus on clarifying risk factors for the development of severe disease to allow for early identification and treatment of those at highest risk.

Automated summary

The study examined the demographic and clinical characteristics of preterm infants with bronchopulmonary dysplasia (BPD) and aimed to identify factors predictive of outpatient mortality. The results showed a significantly higher mortality rate among preterm infants with BPD compared to the general population. The need for greater amounts of home supplemental oxygen and the presence of a gastrostomy tube or cerebrospinal fluid shunt were associated with an increased risk of postdischarge mortality.