title: Prediction of outcome from the chest radiograph appearance on day 7 of very prematurely born infants.
abstract: Our aim was to determine whether the chest radiograph appearance at 7 days predicted chronic lung disease development (oxygen dependency at 36 weeks post-menstrual age) or death before discharge and if it was a better predictor than readily available clinical data. Two consecutive studies were performed. In both, chest radiographs taken at 7 days for clinical purposes were assessed using a scoring system for the presence of fibrosis/interstitial shadows, cystic elements and hyperinflation and data were collected regarding gestational age, birth weight, use of antenatal steroids and post-natal surfactant and requirement for ventilation at 7 days. Oxygenation indices were calculated in the first study (study A) at 120 h and in the second (study B) at 168 h. In study A, there were 59 infants with a median gestational age of 26 weeks (range 24 to 28 weeks) and in study B, 40 infants with a median gestational age of 27 weeks (range 25-31 weeks). In both studies, infants who developed chronic lung disease had a significantly higher total chest radiograph score, with a higher score for fibrosis/interstitial shadowing than the rest of the cohort. Infants who died before discharge differed significantly from the rest with regard to significantly higher scores for cysts. In both studies, the areas under the receiver operator characteristic curves with regard to prediction of chronic lung disease were higher for the total chest radiograph score compared to those for readily available clinical data.
  
  
  CONCLUSIONS
  In infants who require a chest radiograph for clinical purposes at 7 days, the chest radiograph appearance can facilitate prediction of outcome of infants born very prematurely.
authors: Department of Child Health, Guy's, King's and St Thomas' School of Medicine, King's College Hospital, SE5 9RS London, UK. anne.greenough@kcl.ac.uk
authors: Anne
authors: A
authors: Greenough
authors: Mark
authors: M
authors: Thomas
authors: Gabriel
authors: G
authors: Dimitriou
authors: Olivia
authors: O
authors: Williams
authors: Alice
authors: A
authors: Johnson
authors: Elizabeth
authors: E
authors: Limb
authors: Janet
authors: J
authors: Peacock
authors: Neil
authors: N
authors: Marlow
authors: Sandra
authors: S
authors: Calvert
mesh_terms: D002908:Chronic Disease; D015331:Cohort Studies; D005440:Fluid Therapy; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000628:therapy; D010100:Oxygen / Q000627:therapeutic use; D011237:Predictive Value of Tests; D011859:Radiography; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy; D012720:Severity of Illness Index
chemical_list: D010100:Oxygen