Generation of PLASE Score for Patent Ductus Arteriosus Using the PLASE Study Database

Background: No echocardiographic model, to the best of our knowledge, has been established to predict the future need for patent ductus arteriosus (PDA) surgery. This study aimed to develop a novel predictive score (PLASE score) for anticipating the need for PDA surgery using the PLASE study database.

Methods: The included infants with gestational age (GA) < 30 weeks were allocated to derivation and validation groups (2:1). Logistic regression models were constructed to predict the future need for PDA surgery utilizing three clinical and three echocardiographic indices measured at 3 days of age as candidate variables. ROC-AUCs and 95% confidence intervals (CIs) were obtained by 3-fold cross-validation and the percentile method, respectively. The model with the largest ROC-AUC was tested in the validation data.

Results: Derivation and validation data included 463 and 229 patients, respectively, with 55 and 22 surgical cases, respectively. The ROC-AUC was maximized in the model using GA and all three echocardiographic indices (0.846 [95% CI, 0.805-0.886]). In the validation data, the ROC-AUC for the same model was 0.827 (0.744-0.911).

Conclusions: We created a surgical prediction model using simple indices at 3 days of age, and the validation data demonstrated good predictive ability.

Impact: No early predictive model has been established for the future need of patent ductus arteriosus (PDA) surgery in preterm infants. A new prediction model was created with the Patent ductus arteriosus and Left Atrial Size Evaluation study in preterm infants (PLASE) database (N = 692), incorporating gestational age and three simple echocardiographic indices measured at 3 days of age. The model demonstrates high discrimination and calibration. This model provides risk stratification for preterm PDA and may contribute to early preterm management.