Early prediction of poor outcome in extremely low birth weight infants by classification tree analysis.
OBJECTIVE
To predict death or neurodevelopmental impairment (NDI) in extremely low birth weight infants by classification trees with recursive partitioning and automatic selection of optimal cut points of variables.


METHODS
Data from the Trial of Indomethacin Prophylaxis in Preterms were randomly divided into development (n=784) and validation sets (n=262). Three models were developed for the combined outcome of death (8 days to 18 months) or NDI (cerebral palsy, cognitive delay, deafness, or blindness at 18 months corrected age): antenatal: antenatal data; early neonatal: antenatal+first 3 days data; and first week: antenatal, first 3 days, and 4th to 8th days data. Decision trees were tested on the validation set.


RESULTS
Variables associated with death/NDI in each model were: Antenatal: Gestation<or=25.5 weeks and antenatal steroids<7 days. Early neonatal: Birth weight<or=787 g and fluid intake>01 mL/kg/d. First week: Birth weight<or=787 g: transfusion>3 mL/kg/d. Birth weight>787 g: cranial echodense intraparenchymal lesion and transfusion>1 mL/kg/d. Correct classification rates were 61% to 62% for all models.


CONCLUSIONS
The ability to predict long-term morbidity/death in extremely low birth weight infants does not improve significantly over the first week of life. Effects of different variables depend on age.
Ambalavanan
N
N
Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
Baibergenova
A
A
Carlo
W A
WA
Saigal
S
S
Schmidt
B
B
Thorpe
K E
KE
D003663:Decision Trees; D002658:Developmental Disabilities / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D005328:Fetal Viability; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control; D019102:Infant, Very Low Birth Weight; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012680:Sensitivity and Specificity