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. 2013:3:2539.
doi: 10.1038/srep02539.

A predictive model for SIVH risk in preterm infants and targeted indomethacin therapy for prevention

Rachana Singh  1 , Samuel V Gorstein, Frank Bednarek, Joseph H Chou, Elisabeth C McGowan, Paul F Visintainer
Affiliations

A predictive model for SIVH risk in preterm infants and targeted indomethacin therapy for prevention

Rachana Singh et al. Sci Rep. 2013.

Abstract

Prophylactic indomethacin may decrease Severe Intraventricular Hemorrhage (SIVH). Our goal was to develop a predictive model for SIVH using parameters available by six hours of age. De-identified data for preterm infants born ≤ 34 weeks gestational age was abstracted from Vermont Oxford Network database. Using clinical variables available by 6 hrs of age the model was developed, and validated. Statistical methods were used to evaluate the ability of the model to discriminate infants with and without SIVH and, to compare observed and predicted risk. The model achieved excellent discrimination as indicated by ROC curve of 0·85. A good agreement was noted between observed and predicted risk (HLtest: p = 0·22). Application of the model to patients receiving indomethacin suggests a benefit at the highest risk levels. We have developed a valid predictive model for predicting SIVH as well as shown that exposure to indomethacin decreases the incidence of SIVH overall.

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Figures

Figure 1
Figure 1. Box-plot of predicted probabilities for cases and non-cases derived from the final model.
Figure 2
Figure 2. The graph of the observed vs. predicted SIVH risk by risk deciles.
Figure 3
Figure 3. Snapshot of the online calculator which estimates the individual infant's risk of developing SIVH, after providing the seven clinical predictor variables.
Available online via open access at www.neoqic.org.
Figure 4
Figure 4. The plot of the observed vs. predicted risk of severe IVH by risk decile for the Indomethacin exposed group.
See this image and copyright information in PMC

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