Methods of prognosis of the bronchopulmonary dysplasia clinical course in children of one year old
Keywords:bronchopulmonary dysplasia, prognostication of clinical course, groups of catamnestic observation
Aim: to estimate an effectiveness of the different sceneries of bronchopulmonary dysplasia (BPD) prognostication in one year old prematurely born children with perinatal pathology.
Materials and methods. There was carried out an analysis of results of observation on the dynamic of age-specific clinical course of BPD in 105 children from the newborn period till 3 years old. An age-specific dynamics was estimated at three month and at 1 year old. Using methods of mathematical statistics there was studied an influence of postnatal factors on determination of the clinical course and clinical outcome of BPD at the age of 1 year.
Results and discussion. According to the results of observation for the study of the character of postnatal factors influence of BPD dynamic at the age of 1 year there were formed alternative groups: with moderate or significant (including recovery) improvement and insignificant improvement. There were selected the most significant criteria of recovery that were registered at an absence of recovery at BPD. The complex analysis of prognostic importance of the several types of factors demonstrated: the first cluster is represented by BPD clinic at 6 month (Ī=3,62) and BPD severity (Ī=3,52); the second cluster included sex of patient (Ī=1,64), the duration of intensive care (Ī=1,50) and the treatment of surfactant (Ī=1,12); the third cluster is represented by gestational maturity (Ī=0,98) and the state of newborn on Apgar scale (І=0,93) and concomitant pathology is the last one in the rank order (Ī=0,48). In the result of the study there were elaborated the prognostic sceneries that determine the character of BPD clinical course. The use of elaborated prognostic algorithms by the method of characteristic intervals allowed to receive the true prognoses in 87,6% of cases, ambiguous ones – in 8,6 %, and erroneous ones – in 3,8% of cases. The Wald-Genkin procedure revealed its higher reliability especially at erroneous prognoses.
Conclusions. The complex of postnatal factors has an essential influence of age-specific clinical course and clinical outcome of BPD that allows use it for elaboration of the highly reliable criteria of prognostication of BPD development. An establishment of the difference of threshold values of factors that determine the character of clinical course and clinical outcome of BPD allows an elaboration of prognostic sceneries including individual prognostic algorithms on every age period of patient
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