This tool to estimate mortality in chronically ventilated infants with BPD is based on a study performed at the University of Washington to identify prognostic factors for these infants (Pediatrics 1991;88:1153-1160). Potential predictors of mortality were tested by logistic regression analysis. Mean airway pressure and the fraction of inspired oxygen at 60 days of age combined to form the best predictors of mortality after 60 days of age based on the regression model.

To use the tool determine the mean airway pressure and inspired oxygen concentration at 60 days of age and type them into the boxes below then click on the button labelled "Calculate Estimated Mortality". The calculation is based on the results of the logistic regression as outlined below. Before using the results of the calculation please read the limitations inherent in the model as outlined in the article (Pediatrics 1991;88:1153-1160).

The following equation is used to estimate mortality in BPD for infants over 60 days of age (Pediatrics 1991;88:1153-1160) :

                                1
Probability of mortality = -----------
                                 -x
                             1+ e

where x = -7.668 + 0.2940 x MAP60 + 5.935 x FiO2

where MAP is Mean Airway Pressure in cm H2O at 60 days of age
where FiO2 is inspired oxygen concentration at 60 days of age (0.21 - 1.00)

REFERENCES

Source: Pediatrics. 1991 Dec. 88(6). P 1153-60
Title: Estimation of mortality risk in chronically ventilated infants with bronchopulmonary dysplasia
Authors: Overstreet-D-W. Jackson-J-C. van-Belle-G. Truog-W-E.
Institution: University of Washington School of Medicine, Seattle.
Abstract: Bronchopulmonary dysplasia is a chronic, sometimes fatal lung disease, which primarily affects premature infants and often leads to a dependence on mechanical ventilation lasting many months. To identify prognostic factors of mortality at 1 and 2 months of age, the authors reviewed the medical records of the 144 neonates admitted to two neonatal intensive care units in Seattle from January 1, 1986, through December 31, 1988, who required mechanical ventilation throughout the first month of life. Likely predictors of mortality were tested by logistic regression analysis. The calculated mean airway pressure at 30 days of age (MAP30) and the diagnosis of bacterial sepsis at any time during the first month of life (Bact 0-30) were statistically significant predictors of mortality (P less than .001 and P = .018, respectively) and had the lowest deviance in the regression model. The probability of mortality was estimated by 1/(1 + e-chi), where chi = -6.510 + 0.4588 (MAP30) + 1.475 (Bact 0-30), and where MAP30 is expressed as centimeters of water pressure (1 cm H2O = 0.0978 kPa) and the presence or absence of bacteremia is 1 and 0, respectively. The records of the 57 infants who still required mechanical ventilation at 60 days of age were reanalyzed with clinical data available during the first 2 months of life. Mean airway pressure (MAP 60) and the fraction of inspired oxygen (F60) at 60 days of age combined to form the best predictors of mortality, where chi = 7.668 + 0.2940 (MAP 60) + 5.935 (F60).(ABSTRACT TRUNCATED AT 250 WORDS)

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(C) 1995 Peter Tarczy-Hornoch MD