TY - JOUR
T1 - Implementation of a clinical prediction model using daily postnatal weight gain, birth weight, and gestational age to risk stratify ROP
AU - McCauley, Kortany
AU - Chundu, Anupama
AU - Song, Helen
AU - High, Robin
AU - Suh, Donny
N1 - Publisher Copyright:
© 2018 Slack Incorporated. All rights reserved.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Purpose: To develop a simple prognostic model using postnatal weight gain, birth weight, and gestational age to identify infants at risk for developing severe retinopathy of prematurity (ROP). Methods: Medical records from two tertiary referral centers with the diagnosis code “Retinopathy of Prematurity” were evaluated. Those with a birth weight of 1,500 g or less, gestational age of 30 weeks or younger, and unstable clinical courses were included. Multivariate regression analysis was applied to transform three independent variables into a growth rate algorithm. Results: Seventeen of 191 neonates had severe ROP. Weight gain of at least 23 g/d was determined as a protective cut-off value against development of severe ROP. This value maintained 100% sensitivity with 62% specificity to ensure all neonates who require treatment would be captured. Overall, the Omaha (OMA)-ROP model calculated a 58% reduction in eye examinations within the cohort. Conclusions: Inclusion of postnatal growth rate in risk stratification will minimize the number of eye examinations performed without increasing adverse visual outcomes. The OMA-ROP model predicts neonates who gain less than 23 g/d are at higher risk for developing severe ROP. Although promising, larger cohort studies may be necessary to validate and implement new screening practices among preterm infants.
AB - Purpose: To develop a simple prognostic model using postnatal weight gain, birth weight, and gestational age to identify infants at risk for developing severe retinopathy of prematurity (ROP). Methods: Medical records from two tertiary referral centers with the diagnosis code “Retinopathy of Prematurity” were evaluated. Those with a birth weight of 1,500 g or less, gestational age of 30 weeks or younger, and unstable clinical courses were included. Multivariate regression analysis was applied to transform three independent variables into a growth rate algorithm. Results: Seventeen of 191 neonates had severe ROP. Weight gain of at least 23 g/d was determined as a protective cut-off value against development of severe ROP. This value maintained 100% sensitivity with 62% specificity to ensure all neonates who require treatment would be captured. Overall, the Omaha (OMA)-ROP model calculated a 58% reduction in eye examinations within the cohort. Conclusions: Inclusion of postnatal growth rate in risk stratification will minimize the number of eye examinations performed without increasing adverse visual outcomes. The OMA-ROP model predicts neonates who gain less than 23 g/d are at higher risk for developing severe ROP. Although promising, larger cohort studies may be necessary to validate and implement new screening practices among preterm infants.
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U2 - 10.3928/01913913-20180405-02
DO - 10.3928/01913913-20180405-02
M3 - Article
C2 - 29913021
AN - SCOPUS:85053844241
SN - 0191-3913
VL - 55
SP - 326
EP - 334
JO - Journal of pediatric ophthalmology and strabismus
JF - Journal of pediatric ophthalmology and strabismus
IS - 5
ER -