Correlation and predictive value of oxygenation and oxygen saturation indices in extremely preterm infants: a prospective study

AimsThis study aims to evaluate the association between the Oxygenation Index (OI) and the Oxygen Saturation Index (OSI) in extremely preterm infants. In addition, the study seeks to determine the predictive value of these indices for mortality in the first 7 days and Bronchopulmonary Dysplasia (BPD...

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Main Authors: Ibrahim Alanazi, Saleh S. Algarni, Saad Alshreedah, Naif Alotaibi, Mohammed Sufyani, Sami S. Alanazi, Abeer H. Alharthi, Abadi Ghazwani, Omar M. Almutairi, Maryam Alkaabi, Abdulaziz Homedi, Ibrahim Ali, Mohammed Khawaji, Saif Alsaif, Kamal Ali
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1476885/full
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author Ibrahim Alanazi
Saleh S. Algarni
Saleh S. Algarni
Saad Alshreedah
Naif Alotaibi
Mohammed Sufyani
Sami S. Alanazi
Abeer H. Alharthi
Abadi Ghazwani
Omar M. Almutairi
Maryam Alkaabi
Abdulaziz Homedi
Ibrahim Ali
Mohammed Khawaji
Saif Alsaif
Kamal Ali
Kamal Ali
Kamal Ali
author_facet Ibrahim Alanazi
Saleh S. Algarni
Saleh S. Algarni
Saad Alshreedah
Naif Alotaibi
Mohammed Sufyani
Sami S. Alanazi
Abeer H. Alharthi
Abadi Ghazwani
Omar M. Almutairi
Maryam Alkaabi
Abdulaziz Homedi
Ibrahim Ali
Mohammed Khawaji
Saif Alsaif
Kamal Ali
Kamal Ali
Kamal Ali
author_sort Ibrahim Alanazi
collection DOAJ
description AimsThis study aims to evaluate the association between the Oxygenation Index (OI) and the Oxygen Saturation Index (OSI) in extremely preterm infants. In addition, the study seeks to determine the predictive value of these indices for mortality in the first 7 days and Bronchopulmonary Dysplasia (BPD) at 36 weeks postmenstrual age (PMA).MethodsThis is a prospective observational study conducted at King Abdulaziz Medical City, Riyadh between October 2023 and May 2024, involving extremely preterm infants with clinical and ventilator data collected during the first 7 days of life. The predictive capabilities of OI and OSI for mortality within the first 7 days and BPD at 36 wks. PMA were assessed using Area Under the Curve (AUC) analysis, while associations between indices were explored through Spearman's correlation coefficient.ResultsThe study included 85 infants with a mean birth weight of 856 grams (SD = 243) and a mean gestational age of 26 weeks (SD = 1.8). There was a strong positive correlation between OI and OSI overall (r = 0.848, p < 0.001, n = 85), with similar findings in both surviving (r = 0.831, p < 0.001, n = 71) and non-surviving groups (r = 0.896, p < 0.001, n = 14). Bland-Altman plots showed a mean difference of 3 between OI and OSI for all infants, with limits ranging from −4 to +8. Tighter agreement was observed in survivors with a mean difference of 2 and limit from −4 to +7, while non-survivors showed a larger mean difference of 4.5 and wider limits of agreement from −8 to +17. Receiver Operating Characteristic (ROC) analysis for survival prediction focused on indices measured within the first 24 h, demonstrating high predictive accuracy. Additionally, the mean daily values for OI and OSI between Day 4 and Day 7 were found to be predictive of BPD at 36 wk. PMA.ConclusionsMeasurements of OI and OSI within the first 24 h effectively predict mortality in extremely preterm infants. Additionally, daily mean values of OI and OSI from day 4 to day 7 were predictive of BPD at 36 weeks PMA. Further research is needed to refine these diagnostic thresholds to enhance neonatal care outcomes.
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spelling doaj-art-7c29e4ffe4784ab5a42e1c5808aa4d1f2025-08-20T02:48:17ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-02-011310.3389/fped.2025.14768851476885Correlation and predictive value of oxygenation and oxygen saturation indices in extremely preterm infants: a prospective studyIbrahim Alanazi0Saleh S. Algarni1Saleh S. Algarni2Saad Alshreedah3Naif Alotaibi4Mohammed Sufyani5Sami S. Alanazi6Abeer H. Alharthi7Abadi Ghazwani8Omar M. Almutairi9Maryam Alkaabi10Abdulaziz Homedi11Ibrahim Ali12Mohammed Khawaji13Saif Alsaif14Kamal Ali15Kamal Ali16Kamal Ali17Neonatal Intensive Care Department, King Abdulaziz Medical City-Riyadh, Ministry of National Guard Health Affairs, Riyadh, Saudi ArabiaDepartment of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaKing Abdullah International Medical Research Center, Riyadh, Saudi ArabiaNeonatal Intensive Care Department, King Abdulaziz Medical City-Riyadh, Ministry of National Guard Health Affairs, Riyadh, Saudi ArabiaNeonatal Intensive Care Department, King Abdulaziz Medical City-Riyadh, Ministry of National Guard Health Affairs, Riyadh, Saudi ArabiaNeonatal Intensive Care Department, King Abdulaziz Medical City-Riyadh, Ministry of National Guard Health Affairs, Riyadh, Saudi ArabiaNeonatal Intensive Care Department, King Abdulaziz Medical City-Riyadh, Ministry of National Guard Health Affairs, Riyadh, Saudi ArabiaNeonatal Intensive Care Department, King Abdulaziz Medical City-Riyadh, Ministry of National Guard Health Affairs, Riyadh, Saudi ArabiaNeonatal Intensive Care Department, King Abdulaziz Medical City-Riyadh, Ministry of National Guard Health Affairs, Riyadh, Saudi ArabiaNeonatal Intensive Care Department, King Abdulaziz Medical City-Riyadh, Ministry of National Guard Health Affairs, Riyadh, Saudi ArabiaNeonatal Intensive Care Department, King Abdulaziz Medical City-Riyadh, Ministry of National Guard Health Affairs, Riyadh, Saudi ArabiaNeonatal Intensive Care Department, King Abdulaziz Medical City-Riyadh, Ministry of National Guard Health Affairs, Riyadh, Saudi ArabiaNeonatal Intensive Care Department, King Abdulaziz Medical City-Riyadh, Ministry of National Guard Health Affairs, Riyadh, Saudi ArabiaNeonatal Intensive Care Department, King Abdulaziz Medical City-Riyadh, Ministry of National Guard Health Affairs, Riyadh, Saudi ArabiaNeonatal Intensive Care Department, King Abdulaziz Medical City-Riyadh, Ministry of National Guard Health Affairs, Riyadh, Saudi ArabiaNeonatal Intensive Care Department, King Abdulaziz Medical City-Riyadh, Ministry of National Guard Health Affairs, Riyadh, Saudi ArabiaDepartment of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaKing Abdullah International Medical Research Center, Riyadh, Saudi ArabiaAimsThis study aims to evaluate the association between the Oxygenation Index (OI) and the Oxygen Saturation Index (OSI) in extremely preterm infants. In addition, the study seeks to determine the predictive value of these indices for mortality in the first 7 days and Bronchopulmonary Dysplasia (BPD) at 36 weeks postmenstrual age (PMA).MethodsThis is a prospective observational study conducted at King Abdulaziz Medical City, Riyadh between October 2023 and May 2024, involving extremely preterm infants with clinical and ventilator data collected during the first 7 days of life. The predictive capabilities of OI and OSI for mortality within the first 7 days and BPD at 36 wks. PMA were assessed using Area Under the Curve (AUC) analysis, while associations between indices were explored through Spearman's correlation coefficient.ResultsThe study included 85 infants with a mean birth weight of 856 grams (SD = 243) and a mean gestational age of 26 weeks (SD = 1.8). There was a strong positive correlation between OI and OSI overall (r = 0.848, p < 0.001, n = 85), with similar findings in both surviving (r = 0.831, p < 0.001, n = 71) and non-surviving groups (r = 0.896, p < 0.001, n = 14). Bland-Altman plots showed a mean difference of 3 between OI and OSI for all infants, with limits ranging from −4 to +8. Tighter agreement was observed in survivors with a mean difference of 2 and limit from −4 to +7, while non-survivors showed a larger mean difference of 4.5 and wider limits of agreement from −8 to +17. Receiver Operating Characteristic (ROC) analysis for survival prediction focused on indices measured within the first 24 h, demonstrating high predictive accuracy. Additionally, the mean daily values for OI and OSI between Day 4 and Day 7 were found to be predictive of BPD at 36 wk. PMA.ConclusionsMeasurements of OI and OSI within the first 24 h effectively predict mortality in extremely preterm infants. Additionally, daily mean values of OI and OSI from day 4 to day 7 were predictive of BPD at 36 weeks PMA. Further research is needed to refine these diagnostic thresholds to enhance neonatal care outcomes.https://www.frontiersin.org/articles/10.3389/fped.2025.1476885/fulloxygenationindexpretermcorrelationpredictionoutcome
spellingShingle Ibrahim Alanazi
Saleh S. Algarni
Saleh S. Algarni
Saad Alshreedah
Naif Alotaibi
Mohammed Sufyani
Sami S. Alanazi
Abeer H. Alharthi
Abadi Ghazwani
Omar M. Almutairi
Maryam Alkaabi
Abdulaziz Homedi
Ibrahim Ali
Mohammed Khawaji
Saif Alsaif
Kamal Ali
Kamal Ali
Kamal Ali
Correlation and predictive value of oxygenation and oxygen saturation indices in extremely preterm infants: a prospective study
Frontiers in Pediatrics
oxygenation
index
preterm
correlation
prediction
outcome
title Correlation and predictive value of oxygenation and oxygen saturation indices in extremely preterm infants: a prospective study
title_full Correlation and predictive value of oxygenation and oxygen saturation indices in extremely preterm infants: a prospective study
title_fullStr Correlation and predictive value of oxygenation and oxygen saturation indices in extremely preterm infants: a prospective study
title_full_unstemmed Correlation and predictive value of oxygenation and oxygen saturation indices in extremely preterm infants: a prospective study
title_short Correlation and predictive value of oxygenation and oxygen saturation indices in extremely preterm infants: a prospective study
title_sort correlation and predictive value of oxygenation and oxygen saturation indices in extremely preterm infants a prospective study
topic oxygenation
index
preterm
correlation
prediction
outcome
url https://www.frontiersin.org/articles/10.3389/fped.2025.1476885/full
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