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Impressum
Recent evaluation of risk factors by analysis of 2 393 computerized prospective cards for prematures
Mayer U. M., Hornung D. (Thesis D29)
Augenklinik mit Poliklinik der Universität Erlangen-Nürnberg, Schwabachanlage 6, D 91054 Erlangen
Background: With a percentage of 28%, in 1985, children with Retinopathy
of Prematures (ROP) represented a considerable group among the visually
handicaped pupils in Nürnberg. In order to facilitate prophylactic
care, we elaborated a prospective card ; by this mean we were able to
reduce the number of ophthalmoscopies considerably. Examinating only babies
having a Körner-Bossi-Index less than 1,0, the number of screened
babies lowered to 44%. A further number of examinations was not necessary,
if we respected the fact, that we saw no development of ROP before the
34th week.
Methods: This investigation is based on the evaluation of 2 304
Erlanger prospective cards, in which were marked the following risk factors:
The safety index of Körner-Bossi, duration of oxygen therapy in days,
the occurence of a respiratory distress syndrome, of persistence of ductrus
arteriosus Botalli, the number of blood perfusions, of intracerebral hemorrhages,
the occurence of oscillations in blood sugar levels. Considering our 31
babies with ROP stage 1-3 and our 2 393 prospective cards, we were able
to chose 31 babies with the same birth weight and with the same age at
birth; in these matched pairs we looked for the above mentioned risk factors.
Results: There was no correlation to be seen with respiratory distress
syndrome and with the persistence of the ductus arteriosus Botalli. In
these recent investigations, no correlation was seen to the number of
blood transfusions, but the pediatricians had taken care of our warning
in 1993 and reduced the perfused quantity of blood, also because of aids
risc. A clear correlation was to be seen between the duration of passive
respiration, and there was a clear correltation also to intracerebral
hemorrhages. As already described in 1993, in no ROP baby was found a
Körner-Bossi-safety index of more than 1,0; consequently we continue
our risk evaluation in our clinic. A new found risk factor revealed clearly
to consist in oscillations of the serum sugar levels.