title: A predictive model for SIVH risk in preterm infants and targeted indomethacin therapy for prevention.
abstract: Prophylactic indomethacin may decrease Severe Intraventricular Hemorrhage (SIVH). Our goal was to develop a predictive model for SIVH using parameters available by six hours of age. De-identified data for preterm infants born ≤ 34 weeks gestational age was abstracted from Vermont Oxford Network database. Using clinical variables available by 6 hrs of age the model was developed, and validated. Statistical methods were used to evaluate the ability of the model to discriminate infants with and without SIVH and, to compare observed and predicted risk. The model achieved excellent discrimination as indicated by ROC curve of 0·85. A good agreement was noted between observed and predicted risk (HLtest: p = 0·22). Application of the model to patients receiving indomethacin suggests a benefit at the highest risk levels. We have developed a valid predictive model for predicting SIVH as well as shown that exposure to indomethacin decreases the incidence of SIVH overall.
authors.affiliation: Baystate Children's Hospital, Springfield, MA, USA. Rachana.singhmd@bhs.org
authors.forename: Rachana
authors.initials: R
authors.lastname: Singh
authors.forename: Samuel V
authors.initials: SV
authors.lastname: Gorstein
authors.forename: Frank
authors.initials: F
authors.lastname: Bednarek
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Chou
authors.forename: Elisabeth C
authors.initials: EC
authors.lastname: McGowan
authors.forename: Paul F
authors.initials: PF
authors.lastname: Visintainer
mesh_terms: D002543:Cerebral Hemorrhage / Q000188:drug therapy* / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use*; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D007213:Indomethacin