CHEST RADIOGRAPH APPEARANCE AT 24-H OF AGE - PREDICTION OF CHRONIC OXYGEN DEPENDENCY

Chronic oxygen dependence is associated with immaturity, male sex and low birthweight, but amongst that high risk group further criteria are necessary to predict those most at risk. We previously developed a ch est radiograph scoring system which, when used at 1 month of age, prov ed useful in predicting chronic oxygen dependency at 36 weeks post-con ceptional age (PCA). We have now assessed whether the scoring system, if applied at 24 h of age, added predictive value to readily available demographic and ventilatory data. 50 infants, birthweight less than 1 200 g and ventilated from birth, were examined. They had a median gest ational age of 27 weeks (range 23-34), birthweight of 886 g (range 470 -1172) and chest radiograph score of 7 (range 2-13). Univariate analys is revealed that oxygen dependency at 28 days and 36 weeks PCA was sig nificantly associated with low gestational age, male sex and high vent ilatory requirements, in addition to a high chest radiograph score. St epwise regression analysis, however, demonstrated that a high chest ra diograph score predicted oxygen dependence at 28 days, independent of immaturity, low birthweight, male sex and high ventilatory requirement s. A chest radiograph score of more than 5 rendered an infant four tim es more likely to be oxygen dependent at 28 days than those with lower scores. We conclude the chest radiograph appearance at 24 h of age co uld be used as a criterion to institute interventional strategies aime d at reducing chronic oxygen dependence.