Original articleEarly prediction of poor outcome in extremely low birth weight infants by classification tree analysis
Section snippets
Methods
Infants enrolled in the TIPP trial4 who survived beyond 8 days were included for analysis. In the TIPP trial, infants 500 to 999 g birth weight were enrolled from January 1996 to March 1998 at 32 participating centers in Canada, United States, Australia, New Zealand, and Hong Kong. The Institutional Review Board at each center approved the protocol, and informed consent was obtained from parents or legal guardians before entry into the study. NDI was defined as documentation in survivors of 1
Results
Of the 1202 infants enrolled in the TIPP trial, 97 died in the fist week, 13 were lost to follow-up, and 46 did not have all the outcome data necessary to rule out NDI. Therefore 1046 infants were included for analysis. Fifty percent of the infants were male, the mean gestational age was 26.1 weeks (SD 1.9 w; 26), and mean birth weight was 787g (SD 130 g; 795) (Table II). Four hundred thirty-five of the 1046 infants (41.6%) had development of the primary outcome (death 8 days to 18 months or
Discussion
The accumulation of data over the first week of life does not significantly improve the ability of classification trees to predict long-term morbidity/death in ELBW infants who survive beyond the first week of life, irrespective of model complexity. In contrast to the high accuracy of models for predicting early death,12, 13 our study demonstrates the difficulty of predicting long-term morbidity or death in ELBW infants, because correct outcome was predicted in only about 60% of the infants.
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Supported by the Medical Research Council of Canada MT-13288. US centers were supported in part by NICHD U10 HD21364, U10 HD27851, U10 HD21373, U10 HD27881; M01 RR 00997, U10 HD27880; M01 RR 00070, U10 HD21385, U10 HD27904, and U10 HD34216.
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TIPP Investigators listed in the Appendix available at www.jpeds.com.