Prediction of Postdischarge Complications by Predischarge Event Recordings in Infants With Apnea of Prematurity

OBJECTIVE:

To determine whether predischarge event recording (PDER) can accurately identify preterm infants with resolving apnea of prematurity (AOP) at risk for postdischarge complications.

DESIGN:

PDER was performed on infants with resolving AOP on caffeine, ready for discharge. The outcome of infants with normal recordings was compared with that of infants with abnormal recordings. Follow-up data were obtained for outcome.

RESULTS:

Of the 106 infants, 74 had a normal PDER and 32 had an abnormal PDER (apneas lasting for >20 seconds and/or a heart rate of <80 beats per minute for >5 seconds). Birth weight, gestational age at birth, length of stay, discharge weight, and duration of caffeine treatment after discharge were no different between groups. None of the normal PDER infants (0 of 74) had postdischarge complications, whereas 4 of 32 infants with an abnormal PDER had complications ( p  < 0.05, power = 0.7). The positive predictive value of a normal PDER and no postdischarge complications was 100%. The positive predictive value of an abnormal PDER and an adverse outcome was 12.5%.

CONCLUSION: Normal PDER accurately identifies infants at low risk for an adverse outcome.