Predicting Clinical Outcomes of Severe Bronchopulmonary Dysplasia through New Definitions and Phenotypes

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Abstract
Objective: To compare the accuracy of three newly proposed definitions of bronchopulmonary dysplasia (BPD) in predicting outcomes, and to assess the impact of BPD phenotypes (large airway vs. parenchymal vs. vascular disease) on BPD outcomes. Study Design: Retrospective chart review of 100 infants with severe BPD discharged from a Children’s hospital between 2020-2021. Multivariable models evaluated the associations between BPD definitions and phenotypes with tracheostomy and death. Result: Jensen’s and BPD collaborative criteria best predicted outcomes associated with tracheostomy and/or death (p < 0.001). Among the three BPD phenotypes, large airway disease independently predicted death or tracheostomy (OR 10.5, 95% CI 1.6, 68.1). The combination of all three phenotypes also predicted death or tracheostomy (OR 9.8, 95% CI 1.0, 93.5). Conclusion: Newly proposed definitions of BPD better predict outcomes compared to the 2001 NIH definition with BPD phenotypes impacting mortality and short-term outcomes. These data may be useful for counseling families and developing phenotype-based individualized treatment plans.

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