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Brianna C. Aoyama, Jessica L. Rice, Sharon A. McGrath-Morrow and Joseph M. Collaco. Mortality in Outpatients with Bronchopulmonary Dysplasia. The Journal of Pediatrics. 2022 Feb.

Objectives To study the demographic and clinical characteristics of preterm infants with bronchopulmonary
dysplasia (BPD) to identify the factors most strongly predictive of outpatient mortality, with the goal of identifying
those individuals at greatest risk.

Study design Demographic and clinical characteristics were retrospectively reviewed for 862 subjects recruited
from an outpatient BPD clinic. Characteristics of the deceased and living participants were compared using
nonparametric analysis. Regression analysis was performed to identify factors associated with mortality.

Results Of the 862 subjects, 13 (1.5%) died during follow-up, for an overall mortality rate of approximately 15.1
deaths per 1000 subjects. Two patients died in the postneonatal period (annual mortality incidence, 369.9 per

100 000), 9 died between age 1 and 4 years (annual mortality incidence, 310.2 per 100 000), and 2 died between
age of 5 and 14 years (annual mortality incidence, 71.4 per 100 000). After adjusting for gestational age and BPD
severity, mortality was found to be associated with the amount of supplemental oxygen required at discharge
from the neonatal intensive care unit (adjusted hazard ratio [aHR], 4.10; P = .001), presence of a gastrostomy tube (aHR, 8.13; P = .012), and presence of a cerebrospinal fluid (CSF) shunt (aHR, 4.31; P = .021).

Conclusions The incidence of mortality among preterm infants with BPD is substantially higher than that seen in
the general population. The need for greater amounts of home supplemental oxygen and the presence of a
gastrostomy tube or CSF shunt were associated with an increased risk of postdischarge mortality. Future studies
should focus on clarifying risk factors for the development of severe disease to allow for early identification and
treatment of those at highest risk.

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