Multivariate regression analysis of quality of life in neonates with persistent pulmonary hypertension

WANG Huiying; LI Zhengchuan; ZHANG Jianghua

doi:10.3969/j.issn.1002-7386.2024.12.008

Abstract：Objective To analyze the influencing factors for the quality of life in neonates with persistent pulmonary hypertension(PPHN).Methods It was a retrospective study involving 120 PPHN neonates from January 2020 to January 2023.All patients were treated with routine treatment according to the Expert Consensus on the Diagnosis and Treatment of Neonatal Pulmonary Hypertension.According to the prognosis,they were assigned into good quality of life group(good prognosis of improved condition/cure for discharge with oxygenation index increased by more than 20mmHg than baseline)and poor quality of life group(no improvement in symptoms or abandonment/death).The baseline data of the children were collected,and the influencing factors for the quality of life of PPHN were analyzed by binary logistic regression.The receiver operating characteristic(ROC)curve was used to analyze the predictive values of each influencing factor in the quality of life of children with PPHN.Results The proportions of children with hypotension(32.26％[10/31]vs 12.36％[11/89])and acute kidney injury(29.03％[9/31]vs 7.87％[7/89])in the poor quality of life group were significantly higher than those of the good quality of life group(P＜0.05).Serum interleukin 1 β(IL-1 β,[35.63±4.37]ng/L vs[29.37±4.28]ng/L),Von Willebrand factor(vWF,235.64％±15.68％vs 218.37％±14.28％)and high mobility group box protein(HMGB,[28.64±3.37]μg/L vs[24.47±3.19]μg/L)and red cell distribution width(RDW,21.87％±4.18％vs 17.58％±3.64％)were significantly higher in the poor quality of life group than those of the good quality of life group(P＜0.05).The results of binary logistic regression analysis show that hypotension,acute kidney injury,and high serum IL-1β,vWF and HMGB levels were risk factors for poor quality of life in children with PPHN(OR＞1,P＜0.05).ROC curve showed that the area under the curve(AUC)of the combination detection of risk factors for predicting the poor quality of life in children with PPHN was 0.934(95％CI 0.893-0.975,P＜0.001).Conclusion Hypotension,acute kidney injury,serum IL-1β,vWF and HMGB levels are closely related to the quality of life of children with PPHN,and the combination detection of various factors can effectively predict the quality of life of children.