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J Pediatr. 2006 Apr;148(4):438-444.

Early prediction of poor outcome in extremely low birth weight infants by classification tree analysis.

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  • 1Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.

Abstract

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.

STUDY DESIGN:

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.

PMID:
16647401
DOI:
10.1016/j.jpeds.2005.11.042
[PubMed - indexed for MEDLINE]
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