Construction and Validation of a Risk Prediction Model for Early Severe Intraventricular Hemorrhage in Very Low Birth Weight Infants

ABSTRACT In the past several years, prediction models for severe intraventricular hemorrhage (IVH) in premature infants have emerged. However, few models have considered the importance of predictors related to the clinical course and hemostatic profile in predicting the risk of hemorrhage, such as t...

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Main Authors: Fei Shen, Jie Xu, Hui Rong, Jing Zhang, Yang Yang, Xian‐Wen Li
Format: Article
Language:English
Published: Wiley 2025-07-01
Series:Kaohsiung Journal of Medical Sciences
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Online Access:https://doi.org/10.1002/kjm2.70037
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author Fei Shen
Jie Xu
Hui Rong
Jing Zhang
Yang Yang
Xian‐Wen Li
author_facet Fei Shen
Jie Xu
Hui Rong
Jing Zhang
Yang Yang
Xian‐Wen Li
author_sort Fei Shen
collection DOAJ
description ABSTRACT In the past several years, prediction models for severe intraventricular hemorrhage (IVH) in premature infants have emerged. However, few models have considered the importance of predictors related to the clinical course and hemostatic profile in predicting the risk of hemorrhage, such as the FiO2, hematocrit, and platelet count. Moreover, it is noteworthy that most models unreasonably confuse late‐onset IVH with early‐onset, posing a high risk of bias. The present study was performed to construct a new prediction model for severe IVH. The data for this population‐based study came from a children's hospital. After screening by inclusion and exclusion criteria, 1009 very low birth weight infants (VLBWIs) were subsequently recruited in the study and divided into training and validation sets in a ratio of 7:3. Gestational age, Max FiO2, hematokrit on admission < 45%, and platelet count on admission < 100 × 109/L were incorporated into the nomogram chart. The area under the curve (AUC) values demonstrated robust predictive performance, with the training set yielding an AUC of 0.884 (bootstrap‐corrected AUC = 0.903) and the validation set achieving an AUC of 0.859. The Delong test showed no statistically significant difference in AUCs between the training set and validation set (p = 0.528). The result of the Hosmer–Lemeshow test showed the model is well calibrated (p = 0.757). The present study identified the predictor model associated with severe IVH during the first 7 days of life, and the nomogram performed soundly, which would be a promising tool for early stratification of the risk for severe IVH in VLBWIs.
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spelling doaj-art-b7732a397e954686a4ded4d95f1fc6c02025-08-20T03:33:38ZengWileyKaohsiung Journal of Medical Sciences1607-551X2410-86502025-07-01417n/an/a10.1002/kjm2.70037Construction and Validation of a Risk Prediction Model for Early Severe Intraventricular Hemorrhage in Very Low Birth Weight InfantsFei Shen0Jie Xu1Hui Rong2Jing Zhang3Yang Yang4Xian‐Wen Li5Department of Neonatology Children's Hospital of Nanjing Medical University Nanjing People's Republic of ChinaDepartment of Neonatology Children's Hospital of Nanjing Medical University Nanjing People's Republic of ChinaDepartment of Neonatology Children's Hospital of Nanjing Medical University Nanjing People's Republic of ChinaDepartment of Neonatology Children's Hospital of Nanjing Medical University Nanjing People's Republic of ChinaDepartment of Neonatology Children's Hospital of Nanjing Medical University Nanjing People's Republic of ChinaSchool of Nursing Nanjing Medical University Nanjing People's Republic of ChinaABSTRACT In the past several years, prediction models for severe intraventricular hemorrhage (IVH) in premature infants have emerged. However, few models have considered the importance of predictors related to the clinical course and hemostatic profile in predicting the risk of hemorrhage, such as the FiO2, hematocrit, and platelet count. Moreover, it is noteworthy that most models unreasonably confuse late‐onset IVH with early‐onset, posing a high risk of bias. The present study was performed to construct a new prediction model for severe IVH. The data for this population‐based study came from a children's hospital. After screening by inclusion and exclusion criteria, 1009 very low birth weight infants (VLBWIs) were subsequently recruited in the study and divided into training and validation sets in a ratio of 7:3. Gestational age, Max FiO2, hematokrit on admission < 45%, and platelet count on admission < 100 × 109/L were incorporated into the nomogram chart. The area under the curve (AUC) values demonstrated robust predictive performance, with the training set yielding an AUC of 0.884 (bootstrap‐corrected AUC = 0.903) and the validation set achieving an AUC of 0.859. The Delong test showed no statistically significant difference in AUCs between the training set and validation set (p = 0.528). The result of the Hosmer–Lemeshow test showed the model is well calibrated (p = 0.757). The present study identified the predictor model associated with severe IVH during the first 7 days of life, and the nomogram performed soundly, which would be a promising tool for early stratification of the risk for severe IVH in VLBWIs.https://doi.org/10.1002/kjm2.70037intraventricular hemorrhageneonateneurodevelopmental disordersrisk prediction modelvery low birth weight
spellingShingle Fei Shen
Jie Xu
Hui Rong
Jing Zhang
Yang Yang
Xian‐Wen Li
Construction and Validation of a Risk Prediction Model for Early Severe Intraventricular Hemorrhage in Very Low Birth Weight Infants
Kaohsiung Journal of Medical Sciences
intraventricular hemorrhage
neonate
neurodevelopmental disorders
risk prediction model
very low birth weight
title Construction and Validation of a Risk Prediction Model for Early Severe Intraventricular Hemorrhage in Very Low Birth Weight Infants
title_full Construction and Validation of a Risk Prediction Model for Early Severe Intraventricular Hemorrhage in Very Low Birth Weight Infants
title_fullStr Construction and Validation of a Risk Prediction Model for Early Severe Intraventricular Hemorrhage in Very Low Birth Weight Infants
title_full_unstemmed Construction and Validation of a Risk Prediction Model for Early Severe Intraventricular Hemorrhage in Very Low Birth Weight Infants
title_short Construction and Validation of a Risk Prediction Model for Early Severe Intraventricular Hemorrhage in Very Low Birth Weight Infants
title_sort construction and validation of a risk prediction model for early severe intraventricular hemorrhage in very low birth weight infants
topic intraventricular hemorrhage
neonate
neurodevelopmental disorders
risk prediction model
very low birth weight
url https://doi.org/10.1002/kjm2.70037
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