Routine postnatal chest x-ray and intensive care admission are unnecessary for a majority of infants with congenital lung malformations
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Read the article on jpedsurg.org ↗Article · Nov 2018 · 1 min read
In brief
In brief
Study challenges routine NICU admission and chest x-rays for prenatally diagnosed congenital lung malformations, finding these interventions are overused in asymptomatic infants. Analysis of clinical predictors suggests selective imaging and observation could reduce unnecessary resource utilization while maintaining safety.
Written by the GCMD Library team from the article.
Background
Postnatal evaluation of prenatally identified congenital lung malformations (CLMs) often includes a chest x-ray (CXR) and neonatal intensive care unit (NICU) admission for observation. With current efforts aimed at prioritizing value and resource utilization, we sought to assess the utility of this practice in infants with known CLMs. We hypothesized that CXR and NICU admission are overused and could be deferred in the majority of cases.
Methods
Clinical and radiographic data for infants with CLM from 2007 to 2016 were reviewed with IRB approval. Regression models were developed for respiratory support (RS), symptoms within 30 days of discharge (Sx30), and abnormal CXR. Predictors included initial symptoms (IS), birth weight (BW), gestational age (GA), cyst-volume-ratio (CVR) and abnormal CXR. Odds ratios (ORs) and ROC curves were generated for significant predictors (p