The severity grading of patent ductus arteriosus and short-term outcomes

WANG Yi-fei; HE Shao-ru; ZHUANG Jian; SUN Yun-xia; LIANG Sui-xin; CHEN Yan-ling

摘要：Background Contradictory results have been published in the effects of patent ductus arteriosus (PDA) on preterm infants,partly due to the heterogeneity of target populations.How to triage severe PDA infants from mild PDA is still problematic.A Canada PDA triaging system was published to guide PDA surgery triaging.Whether it could be used to predict outcome of preterm infants is uncertain.This study was to determine the effectiveness of this system on predicting short-term outcomes in preterm infants with PDA by 7 days after birth.Methods Twenty-nine preterm infants were confirmed of PDA at 1 week after birth.The charts of these infants were retrospectively reviewed.The Canada PDA triaging system was used to clinically and echocardiographically grade severity of PDA into 4 clinical grades (C1-C4) and 4 echocardiographical grades(E1-E4),with grade 1 the less severe PDA.Baseline characterstics and complications of prematurity were retrieved.Results According to the triaging system,9 infants were classified as C1,14 as C2,5 as C3 and 1 as C4.Meanwhile,0 infants were classified as E1,11 as E2,9 as E3 and 9 as E4 respectively.Under clinical triaging,the incidence of bronchopulmonary dysplasia was significant increased from 11.1％ to 100％ (P=0.002),PDA ligation rates increased from 0％ to 100％ (P=0.035),and length of stay increased from 35±18 days to 86 days (P=0.011).Under echocardiographical grading,there is no statistical significance in any short-term outcomes.Conclusions PDA clinical grading could be used to predict short-term outcomes.