The severity grading of patent ductus arteriosus and shortterm outcomes

Background Contradictory results have been published in the effects of patent ductus arteriosus （PDA） on preterm infants, partly due to the heterogeneity of target populations. How to triage severe PDA infants from mild PDA is still problematic. A Canada PDA triaging system was published to guide PDA surgery triaging. Whether it could be used to predict outcome of preterm infants is uncertain. This study was to determine the effectiveness of this system on predicting short-term outcomes in preterm infants with PDA by 7 days after birth. Methods Twenty-nine preterm infants were confirmed of PDA at 1 week after birth. The charts of these infants were retro- spectively reviewed. The Canada PDA triaging system was used to clinically and echocardiographically grade se- verity of PDA into 4 clinical grades （C1-C4） and 4 echocardiographical grades（El-E4）, with grade 1 the less se- vere PDA. Baseline characteristics and complications of prematurity were retrieved. Results According to the triaging system, 9 infants were classified as C1, 14 as C2, 5 as C3 and 1 as C4. Meanwhile, 0 infants were classi- fied as El, 11 as E2, 9 as E3 and 9 as E4 respectively. Under clinical triaging, the incidence of bronchopulmona- ry dysplasia was significant increased from 11.1% to 100% （P=0.002）, PDA ligation rates increased from 0% to 100% （P=0.035）, and length of stay increased from 35_＋18 days to 86 days （P=0.011）. Under echocardiographical grading, there is no statistical significance in any short-term outcomes. Conclusions PDA clinical grading could be used to predict short-term outcomes.