Evaluation of Oxygen Supplementation Status as a Risk Factor Associated with the Development of Severe Retinopathy of Prematurity

Purpose: The effects of oxygen supplementation status and other clinical risk factors on the development of severe retinopathy of prematurity (ROP) were evaluated. Methods: Clinical records of 143 newborn infants with a gestational age of 32 weeks or less were reviewed. Severe ROP was diagnosed when photocoagulation due to progression to stage 3 was identified or when ‘plus disease' developed. The factors were evaluated with univariate and multivariate logistic regression analyses between the groups with severe (n = 24) and non-severe (n = 119) ROP. Results: Gestational age, birth weight, duration of oxygen supplementation, duration of directional positive air pressure and maximum fraction of inspiratory oxygen (FiO2) were significantly associated with severe ROP in the univariate analyses. In the multivariate analysis, a longer duration of oxygen supplementation and a higher maximum FiO2 were revealed as significant risk factors associated with severe ROP. Conclusions: Duration of oxygen supplementation and maximum FiO2 required were important factors associated with severe ROP.

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Risk Factors Associated with Retinopathy of Prematurity in Very and Extremely Preterm Infants

Medicina ◽

10.3390/medicina57050420 ◽

2021 ◽

Vol 57 (5) ◽

pp. 420

Author(s):

Claudia Ioana Borțea ◽

Florina Stoica ◽

Marioara Boia ◽

Emil Radu Iacob ◽

Mihai Dinu ◽

...

Keyword(s):

Risk Factors ◽

Preterm Infants ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Univariate Analysis ◽

Significant Risk ◽

Extremely Preterm ◽

Extremely Preterm Infants ◽

Surfactant Administration ◽

Stage 1

Background and Objectives: Retinopathy of prematurity (ROP) is the leading cause of blindness in preterm infants. We studied the relationship between different perinatal characteristics, i.e., sex; gestational age (GA); birth weight (BW); C-reactive protein (CRP) and lactate dehydrogenase (LDH) concentrations; ventilation, continuous positive airway pressure (CPAP), and surfactant administration; and the incidence of Stage 1–3 ROP. Materials and Methods: This study included 247 preterm infants with gestational age (GA) < 32 weeks that were successfully screened for ROP. Univariate and multivariate binary analyses were performed to find the most significant risk factors for ROP (Stage 1–3), while multivariate multinomial analysis was used to find the most significant risk factors for specific ROP stages, i.e., Stage 1, 2, and 3. Results: The incidence of ROP (Stage 1–3) was 66.40% (164 infants), while that of Stage 1, 2, and 3 ROP was 15.38% (38 infants), 27.53% (68 infants), and 23.48% (58 infants), respectively. Following univariate analysis, multiple perinatal characteristics, i.e., GA; BW; and ventilation, CPAP, and surfactant administration, were found to be statistically significant risk factors for ROP (p < 0.001). However, in a multivariate model using the same characteristics, only BW and ventilation were significant ROP predictors (p < 0.001 and p < 0.05, respectively). Multivariate multinomial analysis revealed that BW was only significantly correlated with Stage 2 and 3 ROP (p < 0.05 and p < 0.001, respectively), while ventilation was only significantly correlated with Stage 2 ROP (p < 0.05). Conclusions: The results indicate that GA; BW; and the use of ventilation, CPAP, and surfactant were all significant risk factors for ROP (Stage 1–3), but only BW and ventilation were significantly correlated with ROP and specific stages of the disease, namely Stage 2 and 3 ROP and Stage 2 ROP, respectively, in multivariate models.

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Analysis of retinopathy of prematurity screening in Tianjin, China

International Eye Research ◽

10.18240/ier.2020.03.07 ◽

2020 ◽

Vol 1 (3) ◽

pp. 173-178

Author(s):

Mei Han ◽

◽

Jun Zheng ◽

Quan-Hong Han ◽

Li Li ◽

...

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Pulmonary Surfactant ◽

Demographic Information ◽

Oxygen Supplementation ◽

Gestation Age ◽

Multicenter Retrospective Review ◽

The Impact

AIM: To analyze the findings of retinopathy of prematurity (ROP) exam in Tianjin, and study the impact of pulmonary surfactant Curosurf and nasal continuous positive airway pressure (NCPAP) in ROP. METHODS: A multicenter retrospective review. 2894 preterm infants (1592 males, 1302 females) from several hospitals in Tianjin were screened from January 2009 to December 2013. Demographic information, ophthalmic outcomes and possible systemic risk factors were recorded. Gestation age, birth weight, oxygen supplementation, Curosurf and NCPAP were used to estimate risk factors for ROP. RESULTS: ROP was found in 448 eyes of 224 patients (7.7%). Among which, severe ROP developed in 98 eyes of 49 patients (21.9%). There was significant statistical difference in RDS, NCPAP, and Curosurf usage between control and ROP groups (P=0.000). Multiple logistic regression analyses of ROP indicated that lower birth weight, younger gestational age, and oxygen supplementation were the risk factors leading to ROP. As the usage rate of Curosurf and NCPAP increased year by year, the usage of oxygen supplementation gradually decreased, the incidence of ROP was also on the decline. CONCLUSION: Low birth weight, young gestational age and oxygen supplementation are associated with ROP. The use of Curosurf and NCPAP may be the factor that reduces the occurrence of ROP.

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Risk factors associated with retinopathy of prematurity among neonates in a tertiary care hospital in Nepal

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v5i1.18263 ◽

2017 ◽

Vol 5 (1) ◽

pp. 28-33

Author(s):

Jyoti Baba Shrestha ◽

Reena Yadav ◽

Jeevan Kumar Shrestha ◽

Laxman Shrestha ◽

Raman Prasad Sah

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Birth Weight ◽

Neonatal Intensive Care Unit ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Neonatal Intensive Care ◽

Multiple Gestation ◽

Factors Associated

Background: Retinopathy of prematurity is a vascular retinal disease that can cause blindness in premature new born babies. Several risk factors are associated with the incidence of ROP. Information and data on risk factors associated with ROP in context to Nepalese population is scarcely documented in literature.Objectives: The purpose of this study was to evaluate the risk factors of retinopathy of prematurity in premature infants admitted in the neonatal intensive care unit of Tribhuvan University Teaching Hospital.Methods: Neonates with gestational age of 36 weeks or less and birth weight of 2000 gram or less admitted to neonatal intensive care unit (NICU), during 2013 to 2015 were screened for retinopathy of prematurity. Risk factors and severity of retinopathy of prematurity were evaluated. The initial examination was carried out at 4-6 weeks after birth by indirect ophthalmoscope and retinopathy of prematurity positive and negative infants were compared subsequently. The Chisquare and independent t-tests were used for statistical analysis. A p value less than 0.05 was considered statistically signifi cant.Results: The incidence of retinopathy of prematurity was 22.6% and severe retinopathy of prematurity requiring treatment was observed in 3.2% of 93 neonates who had eye examinations. There was a signifi cant relationship between the occurrence of ROP and birth weight (p=0.000), gestational age (p=0.000), duration of oxygen therapy (p=0.009) and sepsis (p=0.002). However, insignifi cant relationship was observed between the occurrence of retinopathy of prematurity and gender, type of delivery, multiple gestation, premature rupture of foetal membrane, respiratory distress syndrome and hyperbilirubinaemia.Conclusion: The risk factors contributing to development of retinopathy of prematurity showed signifi cant relationship with immaturity, duration of oxygen supplementation and septicaemia.Journal of Kathmandu Medical CollegeVol. 5, No. 1, Issue 15, Jan.-Mar., 2016,page: 28-33

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Risk factors associated with conversion of an Ommaya reservoir to a permanent cerebrospinal fluid shunt in preterm posthemorrhagic hydrocephalus

Journal of Neurosurgery Pediatrics ◽

10.3171/2019.11.peds19320 ◽

2020 ◽

Vol 25 (4) ◽

pp. 417-424

Author(s):

Alexis Palpan Flores ◽

Javier Saceda Gutiérrez ◽

Juan Raúl Brin Reyes ◽

Jaime Sierra Tamayo ◽

Fernando Carceller Benito

Keyword(s):

Risk Factors ◽

Gestational Age ◽

Conversion Rate ◽

Ommaya Reservoir ◽

Csf Shunt ◽

Posthemorrhagic Hydrocephalus ◽

Factors Associated ◽

Shunt Group ◽

Csf Lactate ◽

Clinical Records

OBJECTIVEA considerable percentage of preterm infants with posthemorrhagic hydrocephalus initially managed with an Ommaya reservoir require a permanent CSF shunt. The objective of the study was to analyze possible risk factors associated with the need for converting an Ommaya reservoir to a permanent shunt.METHODSThe authors retrospectively reviewed the clinical records of premature infants weighing 1500 g or less with posthemorrhagic hydrocephalus (Papile grades III and IV) managed with an Ommaya reservoir at their institution between 2002 and 2017.RESULTSForty-six patients received an Ommaya reservoir. Five patients (10.9%) were excluded due to intraventricular infection during management with an Ommaya reservoir. Average gestational age and weight for the remaining 41 patients was 27 ± 1.8 weeks and 987 ± 209 grams, respectively. Thirty patients required a permanent shunt and 11 patients did not require a permanent shunt. The conversion rate from an Ommaya reservoir to a permanent shunt was 76.1%. Symptomatic persistent ductus arteriosus (PDA) was more frequent in the nonpermanent shunt group than in the shunt group (88.9% vs 50%, p = 0.04). The need for extraction of more than 10 ml/kg per day of CSF through the Ommaya reservoir was lower in the nonpermanent shunt group than in the shunt group (9.1% vs 51.7%, p = 0.015). CSF lactate was lower in the nonpermanent group than in the shunt group (mean 2.48 mg/dl vs 3.19 mg/dl; p = 0.004). A cutoff value of ≥ 2.8 mg/dl CSF lactate predicted the need for a permanent shunt with sensitivity and specificity of 82.4% and 80%, respectively. There were no significant differences in gestational age, sex, weight, Papile grade, ventricular index, or other biochemical markers. After the multivariate analysis, only CSF lactate ≥ 2.8 mg/dl was associated with a higher conversion rate to a permanent shunt.CONCLUSIONSThis study showed that a high level of CSF lactate, absence of symptomatic PDA, and a higher CSF extraction requirement were associated with a higher likelihood of implanting a permanent CSF shunt. The authors believe these findings should be considered in future studies.

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Pattern and risk factors of retinopathy of prematurity in tertiary care centre

Indian Journal of Clinical and Experimental Ophthalmology ◽

10.18231/j.ijceo.2021.140 ◽

2022 ◽

Vol 7 (4) ◽

pp. 695-698

Author(s):

Snehal Shende ◽

Richa Gour ◽

Veena Melwani ◽

Priti Singh ◽

Kavita Kumar

Keyword(s):

Risk Factors ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Tertiary Care ◽

International Classification ◽

Type I ◽

Care Centre ◽

Tertiary Care Centre ◽

Factors Associated

Retinopathy of prematurity is one of the commonest cause of blindness in sick neonates exposed to excessive oxygen following NICU admissions. The present study was thus conducted to assess the pattern and risk factors associated with incidence of retinopathy of prematurity.A retrospective record based study was conducted at tertiary care centre between 1st July 2017 to 30thMay 2020 were screened for ROP. Baseline characteristics and risk factors for ROP were assessed. The zone and stage of ROP were categorized as per the International classification of ROP along with iris neovascularisation and plus disease as per the revised international classification of retinopathy of prematurity (ICROP) preplus disease criteria. Data was entered in excel sheet and analysed using SPSS software version 20.Majority of neonates belonged to gestational age of 28 to 31 weeks (58.8%) and 51.2% neonates had birthweight of 1.5 to 2 kg. Male preponderance was observed with male: female ratio of 1.75:1. Amongst the various risk factors, the occurrence of ROP was highly significantly associated with gestational age and birthweight (p<0.01). Subgroup analysis revealed that aggressive posterior ROP (APROP) contributed significantly to Type I ROP in 11.1% (3) cases. And the observed difference in gestational age and birthweight between APROP and other cases of ROP were statistically highly significant (p<0.01).Early and timely screening of ROP for all high risk neonates especially low birth weight and neonates with small gestational age should be mandatory as these are the most significant risk factors associated with ROP in present study.

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RETINOPATHY OF PREMATURITY (ROP);

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.04.3375 ◽

2019 ◽

Vol 26 (04) ◽

Author(s):

Muhammad Asghar Ali ◽

Muhammad Anwar ◽

Malik Muhammad Naeem

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Very Low Birth Weight ◽

Male Gender ◽

P Value ◽

Oxygen Supplementation ◽

Cross Sectional

Objectives: To find out Association with risk factors of retinopathy of prematurity (ROP) of in-hospital newborns of low birth weight (LBW). Study Design: Cross sectional study. Setting: Department of Paediatrics, Civil Hospital Bahawalpur. Period: March 2017 to May 2018. Material and Methods: Sixty infants having birth weight 800 gram to 2500 gram, gestational age from 28 weeks to 40 weeks, either male or female were selected. Retinopathy of prematurity (ROP) was assessed in selected patients. Results: Mean gestational age was 32.67 ± 3.8 weeks, mean weight was 1484.17 ± 532.9 gram and mean duration of hospital stay was 14.52 ± 6.6 days. ROP was noted in 20 (33%) patients. Grade I ROP was noted in 11 (55%) patients followed by grade II 7 (35%) and grade III in 2 (10%) patients. Very low birth weight (VLBW), longer duration of oxygen supplementation and male gender were found to be significantly associated (p value < 0.05) with ROP while other variables turned out to be insignificant. Conclusion: Association and risk factors of ROP in LBW infants is high and most of the cases were found with grade I ROP. ROP developed in all very premature infants. Significant association of ROP was noted with VLBW, prolonged duration of oxygen supplementation and male gender.

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Achieved oxygen saturations and retinopathy of prematurity in extreme preterms

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2018-316464 ◽

2019 ◽

Vol 105 (2) ◽

pp. 138-144 ◽

Cited By ~ 1

Author(s):

Marie G Gantz ◽

Waldemar A Carlo ◽

Neil N Finer ◽

Wade Rich ◽

Roger G Faix ◽

...

Keyword(s):

Gestational Age ◽

Retinopathy Of Prematurity ◽

Late Onset ◽

Significant Risk ◽

Research Network ◽

Severe Illness ◽

Oxygen Supplementation ◽

Increased Risk ◽

Extremely Preterm ◽

Postmenstrual Age

ObjectiveTo identify achieved oxygen saturations (SpO2) associated with increased risk of severe retinopathy of prematurity (ROP).DesignThis is a secondary analysis of the Surfactant Positive Airway Pressure and Pulse Oximetry Trial (SUPPORT)randomised controlled trial. SpO2 was recorded up to 36 weeks’ postmenstrual age. Saturations through 9 postnatal weeks were explored graphically, and logistic regression models were created to predict severe ROP.Setting20 centres of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.Patients984 surviving infants of 24–27 weeks’ gestational age born in 2005–2009.InterventionsSUPPORT targeted SpO2 to a lower (85%–89%) or higher (91%–95%) range through 36 weeks’ postmenstrual age or off respiratory support.Main outcome measuresSevere ROP defined as threshold ROP, ophthalmological surgery or bevacizumab treatment.ResultsThere were statistically significant interactions between duration of oxygen supplementation and percentage of time in certain achieved saturation ranges. Specifically, for infants who spent at least 2 weeks on oxygen in postnatal weeks 1–5, a higher percentage of time at 91%–96% SpO2 was associated with increased odds of severe ROP. For infants who spent at least 3 weeks on oxygen in postnatal weeks 6–9, a higher percentage of time at 97%–100% SpO2 was associated with increased odds of severe ROP. Other significant risk factors were lower gestational age and birth weight, non-Hispanic white versus black race, prospectively defined severe illness, late-onset sepsis or meningitis, and clinical centre.ConclusionsAmong extremely preterm survivors to discharge, the association between SpO2 and severe ROP depended on the timing and duration of oxygen supplementation.

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The influence of gestational age on the dynamic behavior of other risk factors associated with retinopathy of prematurity (ROP)

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-009-1248-6 ◽

2009 ◽

Vol 248 (6) ◽

pp. 893-900 ◽

Cited By ~ 30

Author(s):

Joao Borges Fortes Filho ◽

Gabriela Unchalo Eckert ◽

Fabiana Borba Valiatti ◽

Paula Gabriela Batista dos Santos ◽

Marlene Coelho da Costa ◽

...

Keyword(s):

Risk Factors ◽

Dynamic Behavior ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Factors Associated

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Renal Failure after Coronary Bypass Surgery and the Associated Risk Factors

The Heart Surgery Forum ◽

10.1532/hsf.1216 ◽

2015 ◽

Vol 18 (1) ◽

pp. 006

Author(s):

Hasan Reyhanoglu ◽

Kaan Ozcan ◽

Murat Erturk ◽

Fatih İslamoglu ◽

İsa Durmaz

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Renal Failure ◽

Coronary Artery ◽

Coronary Artery Bypass ◽

Bypass Surgery ◽

Artery Bypass ◽

Significant Risk ◽

High Morbidity ◽

Factors Associated

Objective: We aimed to evaluate the risk factors associated with acute renal failure in patients who underwent coronary artery bypass surgery. Methods: One hundred and six patients who developed renal failure after coronary artery bypass grafting (CABG) constituted the study group (RF group), while 110 patients who did not develop renal failure served as a control group (C group). In addition, the RF group was divided into two subgroups: patients that were treated with conservative methods without the need for hemodialysis (NH group) and patients that required hemodialysis (HR group). Risk factors associated with renal failure were investigated. Results: Among the 106 patients that developed renal failure (RF), 80 patients were treated with conservative methods without any need for hemodialysis (NH group); while 26 patients required hemodialysis in the postoperative period (HR group). The multivariate analysis showed that diabetes mellitus and the postoperative use of positive inotropes and adrenaline were significant risk factors associated with development of renal failure. In addition, carotid stenosis and postoperative use of adrenaline were found to be significant risk factors associated with hemodialysis-dependent renal failure (P < .05). The mortality in the RF group was determined as 13.2%, while the mortality rate in patients who did not require hemodialysis and those who required hemodialysis was 6.2% and 34%, respectively. Conclusion: Renal failure requiring hemodialysis after CABG often results in high morbidity and mortality. Factors affecting microcirculation and atherosclerosis, like diabetes mellitus, carotid artery stenosis, and postoperative vasopressor use remain the major risk factors for the development of renal failure.

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Does Vancomycin Resistance Increase Mortality? Clinical Outcomes and Predictive Factors for Mortality in Patients with Enterococcus faecium Infections

Antibiotics ◽

10.3390/antibiotics10020105 ◽

2021 ◽

Vol 10 (2) ◽

pp. 105

Author(s):

Jatapat Hemapanpairoa ◽

Dhitiwat Changpradub ◽

Sudaluck Thunyaharn ◽

Wichai Santimaleeworagun

Keyword(s):

Risk Factors ◽

Clinical Outcomes ◽

Proportional Hazards Model ◽

Significant Risk ◽

Vancomycin Resistance ◽

Cox Proportional Hazards Model ◽

Factors Associated ◽

Joint Infections ◽

Bone And Joint Infections ◽

The Impact

The prevalence of enterococcal infection, especially E. faecium, is increasing, and the issue of the impact of vancomycin resistance on clinical outcomes is controversial. This study aimed to investigate the clinical outcomes of infection caused by E. faecium and determine the risk factors associated with mortality. This retrospective study was performed at the Phramongkutklao Hospital during the period from 2014 to 2018. One hundred and forty-five patients with E. faecium infections were enrolled. The 30-day and 90-day mortality rates of patients infected with vancomycin resistant (VR)-E. faecium vs. vancomycin susceptible (VS)-E. faecium were 57.7% vs. 38.7% and 69.2% vs. 47.1%, respectively. The median length of hospitalization was significantly longer in patients with VR-E. faecium infection. In logistic regression analysis, VR-E. faecium, Sequential Organ Failure Assessment (SOFA) scores, and bone and joint infections were significant risk factors associated with both 30-day and 90-day mortality. Moreover, Cox proportional hazards model showed that VR-E. faecium infection (HR 1.91; 95%CI 1.09–3.37), SOFA scores of 6–9 points (HR 2.69; 95%CI 1.15–6.29), SOFA scores ≥ 10 points (HR 3.71; 95%CI 1.70–8.13), and bone and joint infections (HR 0.08; 95%CI 0.01–0.62) were significant risk factors for mortality. In conclusion, the present study confirmed the impact of VR-E. faecium infection on mortality and hospitalization duration. Thus, the appropriate antibiotic regimen for VR-E. faecium infection, especially for severely ill patients, is an effective strategy for improving treatment outcomes.

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