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A Simpler Prediction Rule for Rebound Hyperbilirubinemia
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| Zeitschriftentitel: | Pediatrics |
|---|---|
| Personen und Körperschaften: | , |
| In: | Pediatrics, 144, 2019, 1 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
American Academy of Pediatrics (AAP)
|
| Schlagwörter: |
| author_facet |
Chang, Pearl W. Newman, Thomas B. Chang, Pearl W. Newman, Thomas B. |
|---|---|
| author |
Chang, Pearl W. Newman, Thomas B. |
| spellingShingle |
Chang, Pearl W. Newman, Thomas B. Pediatrics A Simpler Prediction Rule for Rebound Hyperbilirubinemia Pediatrics, Perinatology and Child Health |
| author_sort |
chang, pearl w. |
| spelling |
Chang, Pearl W. Newman, Thomas B. 0031-4005 1098-4275 American Academy of Pediatrics (AAP) Pediatrics, Perinatology and Child Health http://dx.doi.org/10.1542/peds.2018-3712 <jats:sec> <jats:title /> </jats:sec> <jats:sec> <jats:title>OBJECTIVES:</jats:title> <jats:p>We previously reported a clinical prediction rule to estimate the probability of rebound hyperbilirubinemia using gestational age (GA), age at phototherapy initiation, and total serum bilirubin (TSB) relative to the treatment threshold at phototherapy termination. We investigated (1) how a simpler 2-variable model would perform and (2) the absolute rebound risk if phototherapy were stopped at 2 mg/dL below the threshold for treatment initiation.</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS:</jats:title> <jats:p>Subjects for this retrospective cohort study were infants born 2012–2014 at ≥35 weeks’ gestation at 1 of 17 Kaiser Permanente hospitals who underwent inpatient phototherapy before age 14 days. TSB reaching the phototherapy threshold within 72 hours of phototherapy termination was considered rebound. We simplified by using the difference between the TSB level at the time of phototherapy termination and the treatment threshold at the time of phototherapy initiation as 1 predictor, and kept GA as the other predictor.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS:</jats:title> <jats:p>Of the 7048 infants treated with phototherapy, 4.6% had rebound hyperbilirubinemia. The area under the receiver operating characteristic curve was 0.876 (95% confidence interval, 0.854 to 0.899) for the 2-variable model versus 0.881 (95% confidence interval, 0.859 to 0.903) for the 3-variable model. The rebound probability after stopping phototherapy at 2 mg/dL below the starting threshold was 2.5% for infants ≥38 weeks’ GA and 10.2% for infants &lt;38 weeks’ GA.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS:</jats:title> <jats:p>Rebound hyperbilirubinemia can be predicted by a simpler 2-variable model consisting of GA and the starting threshold–ending TSB difference. Infants &lt;38 weeks’ gestation may need longer phototherapy because of their higher rebound risk.</jats:p> </jats:sec> A Simpler Prediction Rule for Rebound Hyperbilirubinemia Pediatrics |
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10.1542/peds.2018-3712 |
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American Academy of Pediatrics (AAP), 2019 |
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American Academy of Pediatrics (AAP), 2019 |
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0031-4005 1098-4275 |
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0031-4005 1098-4275 |
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American Academy of Pediatrics (AAP) |
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Pediatrics |
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| title |
A Simpler Prediction Rule for Rebound Hyperbilirubinemia |
| title_unstemmed |
A Simpler Prediction Rule for Rebound Hyperbilirubinemia |
| title_full |
A Simpler Prediction Rule for Rebound Hyperbilirubinemia |
| title_fullStr |
A Simpler Prediction Rule for Rebound Hyperbilirubinemia |
| title_full_unstemmed |
A Simpler Prediction Rule for Rebound Hyperbilirubinemia |
| title_short |
A Simpler Prediction Rule for Rebound Hyperbilirubinemia |
| title_sort |
a simpler prediction rule for rebound hyperbilirubinemia |
| topic |
Pediatrics, Perinatology and Child Health |
| url |
http://dx.doi.org/10.1542/peds.2018-3712 |
| publishDate |
2019 |
| physical |
|
| description |
<jats:sec>
<jats:title />
</jats:sec>
<jats:sec>
<jats:title>OBJECTIVES:</jats:title>
<jats:p>We previously reported a clinical prediction rule to estimate the probability of rebound hyperbilirubinemia using gestational age (GA), age at phototherapy initiation, and total serum bilirubin (TSB) relative to the treatment threshold at phototherapy termination. We investigated (1) how a simpler 2-variable model would perform and (2) the absolute rebound risk if phototherapy were stopped at 2 mg/dL below the threshold for treatment initiation.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>METHODS:</jats:title>
<jats:p>Subjects for this retrospective cohort study were infants born 2012–2014 at ≥35 weeks’ gestation at 1 of 17 Kaiser Permanente hospitals who underwent inpatient phototherapy before age 14 days. TSB reaching the phototherapy threshold within 72 hours of phototherapy termination was considered rebound. We simplified by using the difference between the TSB level at the time of phototherapy termination and the treatment threshold at the time of phototherapy initiation as 1 predictor, and kept GA as the other predictor.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>RESULTS:</jats:title>
<jats:p>Of the 7048 infants treated with phototherapy, 4.6% had rebound hyperbilirubinemia. The area under the receiver operating characteristic curve was 0.876 (95% confidence interval, 0.854 to 0.899) for the 2-variable model versus 0.881 (95% confidence interval, 0.859 to 0.903) for the 3-variable model. The rebound probability after stopping phototherapy at 2 mg/dL below the starting threshold was 2.5% for infants ≥38 weeks’ GA and 10.2% for infants &lt;38 weeks’ GA.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>CONCLUSIONS:</jats:title>
<jats:p>Rebound hyperbilirubinemia can be predicted by a simpler 2-variable model consisting of GA and the starting threshold–ending TSB difference. Infants &lt;38 weeks’ gestation may need longer phototherapy because of their higher rebound risk.</jats:p>
</jats:sec> |
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| author | Chang, Pearl W., Newman, Thomas B. |
| author_facet | Chang, Pearl W., Newman, Thomas B., Chang, Pearl W., Newman, Thomas B. |
| author_sort | chang, pearl w. |
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| description | <jats:sec> <jats:title /> </jats:sec> <jats:sec> <jats:title>OBJECTIVES:</jats:title> <jats:p>We previously reported a clinical prediction rule to estimate the probability of rebound hyperbilirubinemia using gestational age (GA), age at phototherapy initiation, and total serum bilirubin (TSB) relative to the treatment threshold at phototherapy termination. We investigated (1) how a simpler 2-variable model would perform and (2) the absolute rebound risk if phototherapy were stopped at 2 mg/dL below the threshold for treatment initiation.</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS:</jats:title> <jats:p>Subjects for this retrospective cohort study were infants born 2012–2014 at ≥35 weeks’ gestation at 1 of 17 Kaiser Permanente hospitals who underwent inpatient phototherapy before age 14 days. TSB reaching the phototherapy threshold within 72 hours of phototherapy termination was considered rebound. We simplified by using the difference between the TSB level at the time of phototherapy termination and the treatment threshold at the time of phototherapy initiation as 1 predictor, and kept GA as the other predictor.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS:</jats:title> <jats:p>Of the 7048 infants treated with phototherapy, 4.6% had rebound hyperbilirubinemia. The area under the receiver operating characteristic curve was 0.876 (95% confidence interval, 0.854 to 0.899) for the 2-variable model versus 0.881 (95% confidence interval, 0.859 to 0.903) for the 3-variable model. The rebound probability after stopping phototherapy at 2 mg/dL below the starting threshold was 2.5% for infants ≥38 weeks’ GA and 10.2% for infants &lt;38 weeks’ GA.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS:</jats:title> <jats:p>Rebound hyperbilirubinemia can be predicted by a simpler 2-variable model consisting of GA and the starting threshold–ending TSB difference. Infants &lt;38 weeks’ gestation may need longer phototherapy because of their higher rebound risk.</jats:p> </jats:sec> |
| doi_str_mv | 10.1542/peds.2018-3712 |
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| imprint | American Academy of Pediatrics (AAP), 2019 |
| imprint_str_mv | American Academy of Pediatrics (AAP), 2019 |
| institution | DE-D275, DE-Bn3, DE-Brt1, DE-Zwi2, DE-D161, DE-Gla1, DE-Zi4, DE-15, DE-Pl11, DE-Rs1, DE-105, DE-14, DE-Ch1, DE-L229 |
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| publisher | American Academy of Pediatrics (AAP) |
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| series | Pediatrics |
| source_id | 49 |
| spelling | Chang, Pearl W. Newman, Thomas B. 0031-4005 1098-4275 American Academy of Pediatrics (AAP) Pediatrics, Perinatology and Child Health http://dx.doi.org/10.1542/peds.2018-3712 <jats:sec> <jats:title /> </jats:sec> <jats:sec> <jats:title>OBJECTIVES:</jats:title> <jats:p>We previously reported a clinical prediction rule to estimate the probability of rebound hyperbilirubinemia using gestational age (GA), age at phototherapy initiation, and total serum bilirubin (TSB) relative to the treatment threshold at phototherapy termination. We investigated (1) how a simpler 2-variable model would perform and (2) the absolute rebound risk if phototherapy were stopped at 2 mg/dL below the threshold for treatment initiation.</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS:</jats:title> <jats:p>Subjects for this retrospective cohort study were infants born 2012–2014 at ≥35 weeks’ gestation at 1 of 17 Kaiser Permanente hospitals who underwent inpatient phototherapy before age 14 days. TSB reaching the phototherapy threshold within 72 hours of phototherapy termination was considered rebound. We simplified by using the difference between the TSB level at the time of phototherapy termination and the treatment threshold at the time of phototherapy initiation as 1 predictor, and kept GA as the other predictor.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS:</jats:title> <jats:p>Of the 7048 infants treated with phototherapy, 4.6% had rebound hyperbilirubinemia. The area under the receiver operating characteristic curve was 0.876 (95% confidence interval, 0.854 to 0.899) for the 2-variable model versus 0.881 (95% confidence interval, 0.859 to 0.903) for the 3-variable model. The rebound probability after stopping phototherapy at 2 mg/dL below the starting threshold was 2.5% for infants ≥38 weeks’ GA and 10.2% for infants &lt;38 weeks’ GA.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS:</jats:title> <jats:p>Rebound hyperbilirubinemia can be predicted by a simpler 2-variable model consisting of GA and the starting threshold–ending TSB difference. Infants &lt;38 weeks’ gestation may need longer phototherapy because of their higher rebound risk.</jats:p> </jats:sec> A Simpler Prediction Rule for Rebound Hyperbilirubinemia Pediatrics |
| spellingShingle | Chang, Pearl W., Newman, Thomas B., Pediatrics, A Simpler Prediction Rule for Rebound Hyperbilirubinemia, Pediatrics, Perinatology and Child Health |
| title | A Simpler Prediction Rule for Rebound Hyperbilirubinemia |
| title_full | A Simpler Prediction Rule for Rebound Hyperbilirubinemia |
| title_fullStr | A Simpler Prediction Rule for Rebound Hyperbilirubinemia |
| title_full_unstemmed | A Simpler Prediction Rule for Rebound Hyperbilirubinemia |
| title_short | A Simpler Prediction Rule for Rebound Hyperbilirubinemia |
| title_sort | a simpler prediction rule for rebound hyperbilirubinemia |
| title_unstemmed | A Simpler Prediction Rule for Rebound Hyperbilirubinemia |
| topic | Pediatrics, Perinatology and Child Health |
| url | http://dx.doi.org/10.1542/peds.2018-3712 |