Cargando…

Development of a Nomogram for Moderate-to-Severe Bronchopulmonary Dysplasia or Death: Role of N-Terminal Pro-brain Natriuretic Peptide as a Biomarker

Objectives: This study aimed to explore the clinical value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in predicting moderate-to-severe bronchopulmonary dysplasia (BPD)/death, and to establish an effective clinical predictive nomogram. Methods: We retrospectively analyzed very low birth...

Descripción completa

Detalles Bibliográficos
Autores principales: Song, Min, Lei, Mengyuan, Luo, Chenghan, Shi, Zanyang, Cheng, Xinru, Ding, Wenqian, Cao, Wenjun, Zhang, Jingdi, Ge, Jian, Wang, Mengmeng, Xia, Peige, Mao, Fengxia, Wang, Li, Zhang, Qian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8419419/
https://www.ncbi.nlm.nih.gov/pubmed/34497786
http://dx.doi.org/10.3389/fped.2021.727362
_version_ 1783748748211388416
author Song, Min
Lei, Mengyuan
Luo, Chenghan
Shi, Zanyang
Cheng, Xinru
Ding, Wenqian
Cao, Wenjun
Zhang, Jingdi
Ge, Jian
Wang, Mengmeng
Xia, Peige
Mao, Fengxia
Wang, Li
Zhang, Qian
author_facet Song, Min
Lei, Mengyuan
Luo, Chenghan
Shi, Zanyang
Cheng, Xinru
Ding, Wenqian
Cao, Wenjun
Zhang, Jingdi
Ge, Jian
Wang, Mengmeng
Xia, Peige
Mao, Fengxia
Wang, Li
Zhang, Qian
author_sort Song, Min
collection PubMed
description Objectives: This study aimed to explore the clinical value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in predicting moderate-to-severe bronchopulmonary dysplasia (BPD)/death, and to establish an effective clinical predictive nomogram. Methods: We retrospectively analyzed very low birth weight infants (VLBWs) with gestational age ≤ 32 weeks. The NT-proBNP values were determined on the 1st, 3rd, 7th, 14th, 21st, and 28th days after birth. The correlation between NT-proBNP level and moderate-to-severe BPD/death was evaluated. Receiver operating characteristic (ROC) curve analysis was used to evaluate the prediction ability. Then, we used multivariable logistic regression to build the prediction model and nomogram, and calibration of the model was assessed by calibration curve. Results: In total, 556 VLBWs were involved, among whom 229 developed BPD (mild: n = 109; moderate: n = 68; severe: n = 52) and 18 died. The NT-proBNP level in the moderate-to-severe BPD/death group was significantly higher than that in the no-to-mild BPD group from the 3rd to 28th day (P < 0.001). When the natural logarithm of the serum NT-ProBNP level increased by 1 unit at day 7 (±2 days) of life, the risk of moderate and severe BPD/death was the highest (OR = 3.753; 95% CI: 2.984~4.720), and ROC analysis identified an optimal cutoff point of 3360 ng/L (sensitivity: 80.0%; specificity: 86.2%; AUC: 0.861). After adjusting for confounding factors, the level of NT-proBNP at day 7 (±2 days) of life still had important predictive value for the development of moderate-to-severe BPD/death, significantly improving the predictive ability of the model. Conclusion: The level of NT-proBNP at day 7 (±2 days) of life can be used as an early promising biomarker for VLBWs to develop moderate-to-severe BPD/death. We constructed an early predictive nomogram to help clinicians identify high-risk populations.
format Online
Article
Text
id pubmed-8419419
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-84194192021-09-07 Development of a Nomogram for Moderate-to-Severe Bronchopulmonary Dysplasia or Death: Role of N-Terminal Pro-brain Natriuretic Peptide as a Biomarker Song, Min Lei, Mengyuan Luo, Chenghan Shi, Zanyang Cheng, Xinru Ding, Wenqian Cao, Wenjun Zhang, Jingdi Ge, Jian Wang, Mengmeng Xia, Peige Mao, Fengxia Wang, Li Zhang, Qian Front Pediatr Pediatrics Objectives: This study aimed to explore the clinical value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in predicting moderate-to-severe bronchopulmonary dysplasia (BPD)/death, and to establish an effective clinical predictive nomogram. Methods: We retrospectively analyzed very low birth weight infants (VLBWs) with gestational age ≤ 32 weeks. The NT-proBNP values were determined on the 1st, 3rd, 7th, 14th, 21st, and 28th days after birth. The correlation between NT-proBNP level and moderate-to-severe BPD/death was evaluated. Receiver operating characteristic (ROC) curve analysis was used to evaluate the prediction ability. Then, we used multivariable logistic regression to build the prediction model and nomogram, and calibration of the model was assessed by calibration curve. Results: In total, 556 VLBWs were involved, among whom 229 developed BPD (mild: n = 109; moderate: n = 68; severe: n = 52) and 18 died. The NT-proBNP level in the moderate-to-severe BPD/death group was significantly higher than that in the no-to-mild BPD group from the 3rd to 28th day (P < 0.001). When the natural logarithm of the serum NT-ProBNP level increased by 1 unit at day 7 (±2 days) of life, the risk of moderate and severe BPD/death was the highest (OR = 3.753; 95% CI: 2.984~4.720), and ROC analysis identified an optimal cutoff point of 3360 ng/L (sensitivity: 80.0%; specificity: 86.2%; AUC: 0.861). After adjusting for confounding factors, the level of NT-proBNP at day 7 (±2 days) of life still had important predictive value for the development of moderate-to-severe BPD/death, significantly improving the predictive ability of the model. Conclusion: The level of NT-proBNP at day 7 (±2 days) of life can be used as an early promising biomarker for VLBWs to develop moderate-to-severe BPD/death. We constructed an early predictive nomogram to help clinicians identify high-risk populations. Frontiers Media S.A. 2021-08-23 /pmc/articles/PMC8419419/ /pubmed/34497786 http://dx.doi.org/10.3389/fped.2021.727362 Text en Copyright © 2021 Song, Lei, Luo, Shi, Cheng, Ding, Cao, Zhang, Ge, Wang, Xia, Mao, Wang and Zhang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Song, Min
Lei, Mengyuan
Luo, Chenghan
Shi, Zanyang
Cheng, Xinru
Ding, Wenqian
Cao, Wenjun
Zhang, Jingdi
Ge, Jian
Wang, Mengmeng
Xia, Peige
Mao, Fengxia
Wang, Li
Zhang, Qian
Development of a Nomogram for Moderate-to-Severe Bronchopulmonary Dysplasia or Death: Role of N-Terminal Pro-brain Natriuretic Peptide as a Biomarker
title Development of a Nomogram for Moderate-to-Severe Bronchopulmonary Dysplasia or Death: Role of N-Terminal Pro-brain Natriuretic Peptide as a Biomarker
title_full Development of a Nomogram for Moderate-to-Severe Bronchopulmonary Dysplasia or Death: Role of N-Terminal Pro-brain Natriuretic Peptide as a Biomarker
title_fullStr Development of a Nomogram for Moderate-to-Severe Bronchopulmonary Dysplasia or Death: Role of N-Terminal Pro-brain Natriuretic Peptide as a Biomarker
title_full_unstemmed Development of a Nomogram for Moderate-to-Severe Bronchopulmonary Dysplasia or Death: Role of N-Terminal Pro-brain Natriuretic Peptide as a Biomarker
title_short Development of a Nomogram for Moderate-to-Severe Bronchopulmonary Dysplasia or Death: Role of N-Terminal Pro-brain Natriuretic Peptide as a Biomarker
title_sort development of a nomogram for moderate-to-severe bronchopulmonary dysplasia or death: role of n-terminal pro-brain natriuretic peptide as a biomarker
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8419419/
https://www.ncbi.nlm.nih.gov/pubmed/34497786
http://dx.doi.org/10.3389/fped.2021.727362
work_keys_str_mv AT songmin developmentofanomogramformoderatetoseverebronchopulmonarydysplasiaordeathroleofnterminalprobrainnatriureticpeptideasabiomarker
AT leimengyuan developmentofanomogramformoderatetoseverebronchopulmonarydysplasiaordeathroleofnterminalprobrainnatriureticpeptideasabiomarker
AT luochenghan developmentofanomogramformoderatetoseverebronchopulmonarydysplasiaordeathroleofnterminalprobrainnatriureticpeptideasabiomarker
AT shizanyang developmentofanomogramformoderatetoseverebronchopulmonarydysplasiaordeathroleofnterminalprobrainnatriureticpeptideasabiomarker
AT chengxinru developmentofanomogramformoderatetoseverebronchopulmonarydysplasiaordeathroleofnterminalprobrainnatriureticpeptideasabiomarker
AT dingwenqian developmentofanomogramformoderatetoseverebronchopulmonarydysplasiaordeathroleofnterminalprobrainnatriureticpeptideasabiomarker
AT caowenjun developmentofanomogramformoderatetoseverebronchopulmonarydysplasiaordeathroleofnterminalprobrainnatriureticpeptideasabiomarker
AT zhangjingdi developmentofanomogramformoderatetoseverebronchopulmonarydysplasiaordeathroleofnterminalprobrainnatriureticpeptideasabiomarker
AT gejian developmentofanomogramformoderatetoseverebronchopulmonarydysplasiaordeathroleofnterminalprobrainnatriureticpeptideasabiomarker
AT wangmengmeng developmentofanomogramformoderatetoseverebronchopulmonarydysplasiaordeathroleofnterminalprobrainnatriureticpeptideasabiomarker
AT xiapeige developmentofanomogramformoderatetoseverebronchopulmonarydysplasiaordeathroleofnterminalprobrainnatriureticpeptideasabiomarker
AT maofengxia developmentofanomogramformoderatetoseverebronchopulmonarydysplasiaordeathroleofnterminalprobrainnatriureticpeptideasabiomarker
AT wangli developmentofanomogramformoderatetoseverebronchopulmonarydysplasiaordeathroleofnterminalprobrainnatriureticpeptideasabiomarker
AT zhangqian developmentofanomogramformoderatetoseverebronchopulmonarydysplasiaordeathroleofnterminalprobrainnatriureticpeptideasabiomarker