Comparison of lung ultrasound scores with clinical models for predicting bronchopulmonary dysplasia

Lung ultrasound scores (LUSs) have been demonstrated to accurately predict moderate-to-severe bronchopulmonary dysplasia (msBPD). This study attempted to explore the additional value of LUSs for predicting msBPD compared to clinical multivariate models in different gestational age (GA) groups. The study prospectively recruited preterm infants with GA < 32 weeks. Lung ultrasound was performed on days 3, 7, 14, and 21 after birth. A linear mixed-effects regression model was used to evaluate LUS evolution in infants born before and after 28 weeks. The receiver operating characteristic (ROC) procedure was used to analyze the reliability of LUS and clinical multivariable models for predicting msBPD. The optimal time to predict msBPD in all infants was 7 days with a cut-off point of 5 (area under the ROC (AUROC) curve: 0.78, 95% confidence interval (CI): 0.71–0.84). In infants with GA ≥ 28 weeks, LUSs provided a moderate diagnostic accuracy for all four time points (AUROC curve: 0.74–0.78), and the AUROC curve for the clinical multivariable model on day 14 was 0.91 (95% CI: 0.84–0.96), which was significantly higher than that of LUSs (AUROC curve: 0.77, 95% CI: 0.68–0.85, P < 0.05). In infants born at 23–27 weeks, LUSs showed a low diagnostic accuracy with higher cut-off points to predict msBPD, and the AUROC curve for GA to predict msBPD was 0.75 (95% CI: 0.59–0.85), providing diagnostic accuracy similar to that of LUSs. Conclusion: The contribution of LUSs to predict msBPD in infants with different GAs remains controversial and requires further investigation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00431-023-04847-y.