PURPOSE: Use of pneumograms for the management of apnea of prematurity (AOP) is controversial. In this study, we used pneumogram results to assess if prolonged central apnea (CA) was an independent risk factor for readmission for apnea after discharge from the NICU.
METHODS: Retrospective chart review. Inclusion: consecutive infants born at < 36 weeks gestational age who had a 5 channel pneumogram study prior to discharge from our NICU during time period 1/1/2002-7/31/2004. Prolonged central apnea (CA) was defined as at least one event with cessation of nasal airflow and chest effort for > 20 seconds. Comprehensive medical records were reviewed to identify infants readmitted with apnea after discharge from the NICU. Infants readmitted for non-idiopathic causes of apnea (e.g., gastroesophageal reflux) were excluded. Stratified analysis was used to assess the variables confounding the relationship between CA and readmission for apnea. Logistic regression analysis was used to assess if prolonged CA was an independent risk factor for apnea readmission, controlling for the confounding variables (SAS software). Study was IRB approved.
RESULTS: 440 pneumogram studies were done during the time period. 25 studies were excluded due to unavailability of results. Of the remaining 415 studies, 53 showed prolonged CA (CA group) and 362 showed no prolonged CA (control group). CA and control groups were similar with regard to the following: duration of follow-up (mean for CA group: 2.2 yrs; for controls: 2.4 yrs), duration of NICU stay, gestational age, and birth weight. The incidence of readmission for apnea in the CA group was 13.2 % compared with 4.7% in controls. On logistic regression analysis, prolonged CA was an independent risk factor for readmission for apnea (odds ratio: 3.33, 95% CI: 1.24-8.96).
CONCLUSION: Central apnea over 20 seconds in duration identified in the NICU was an independent risk factor for subsequent readmission for apnea after NICU discharge.
CLINICAL IMPLICATIONS: Our results suggest that pneumograms may have a role in the NICU, since identification of prolonged CA may have important predictive clinical implications.
DISCLOSURE: Tushar Shah, No Financial Disclosure Information; No Product/Research Disclosure Information