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Prediction score for prolonged hospital stay in Meconium aspiration syndrome: A Multicentric collaborative cohort of South India
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  • Poornachandra Rao,
  • Siddu Charki,
  • Abhishek Aradhya ,
  • shivashankar diggikar,
  • Archana Bilagi,
  • Praveen Venkatagiri,
  • Tanmaya Tyagaraj,
  • Srikant Kulkarni ,
  • Vinutha Nagareddy G,
  • Vijaykumar Biradar S,
  • Patricia Lewis,
  • Patil MM
Poornachandra Rao
Ovum Woman & Child Specialty Hospital, Hoskote

Corresponding Author:[email protected]

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Siddu Charki
Shri BM Patil Medical College & Research centre
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Abhishek Aradhya
Ovum Woman & Child Specialty Hospital, Hoskote
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shivashankar diggikar
Ovum Woman & Child Specialty Hospital, Kalyan Nagar
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Archana Bilagi
St. Philomena hospital, Bangalore
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Praveen Venkatagiri
Chinmaya Mission Hospital
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Tanmaya Tyagaraj
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Srikant Kulkarni
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Vinutha Nagareddy G
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Vijaykumar Biradar S
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Patricia Lewis
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Abstract

Background and Objective: With improved survival in neonates with meconium aspiration syndrome (MAS), the focus is currently on mitigating the morbidities. The objective of this study was to predict factors determining prolonged hospital stay in neonates with MAS. Materials and methods: It was a retrospective cohort from five centres of south India between 2018 and 2020. Neonates ≥35 weeks of gestation admitted to NICU with the diagnosis of MAS and requiring oxygen beyond 24 hours of life were included in the study. The morbidities in the neonates with stay ≤7 days (short stay) were compared with >7 days (prolonged stay). Logistic regression by the backward stepwise method was used for predictive score creation. Results: Out of 347 neonates with MAS discharged home, 103 (29%) had a short stay and 244 (71%) had prolonged stay. The primary support beyond O2 (CPAP/MV) (42% vs 83%, p<0.001), FiO2 at 1hr>30% (45% vs 87%, p<0.001), HIE stage 2 or 3 (2% vs 27%, p<0.001), moderate-severe PPHN (3% vs 31%, p<0.001) were independent factors associated with prolonged stay on logistic regression. A prediction model was devised using weighted scores of these four associated morbidities. The clinical score thus developed had 83% sensitivity, 68% specificity for the prediction of prolonged stay [AUC- 82, 95% CI (78-87), p<0.001]. Conclusion: More than two-thirds of neonates with MAS had prolonged stay. The primary support beyond oxygen, Fio2 requirement >30%, Moderate to severe PPHN, HIE stage 2 or 3 were predictive of prolonged stay in neonates with MAS.
11 Apr 2022Submitted to Pediatric Pulmonology
11 Apr 2022Submission Checks Completed
11 Apr 2022Assigned to Editor
11 Apr 2022Reviewer(s) Assigned
26 Apr 2022Review(s) Completed, Editorial Evaluation Pending
26 Apr 2022Editorial Decision: Revise Minor
06 May 20221st Revision Received
06 May 2022Assigned to Editor
06 May 2022Submission Checks Completed
06 May 2022Reviewer(s) Assigned
14 Jun 2022Review(s) Completed, Editorial Evaluation Pending
14 Jun 2022Editorial Decision: Revise Minor
15 Jun 20222nd Revision Received
15 Jun 2022Submission Checks Completed
15 Jun 2022Assigned to Editor
15 Jun 2022Reviewer(s) Assigned
17 Jun 2022Review(s) Completed, Editorial Evaluation Pending
19 Jun 2022Editorial Decision: Accept
04 Jul 2022Published in Pediatric Pulmonology. 10.1002/ppul.26044