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1071 Is low platelet count at start of medical treatment for patent ductus arteriosus (PDA) ligation a predictor of requirement for surgical ligation?

Archives of disease in childhood, 2021-10, Vol.106 (Suppl 1), p.A215-A215 [Peer Reviewed Journal]

Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ. ;2021 Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ. ;ISSN: 0003-9888 ;EISSN: 1468-2044 ;DOI: 10.1136/archdischild-2021-rcpch.375

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  • Title:
    1071 Is low platelet count at start of medical treatment for patent ductus arteriosus (PDA) ligation a predictor of requirement for surgical ligation?
  • Author: Mitchell, Annelies ; Thwaites, Richard
  • Subjects: Abstracts ; Birth weight ; Gestational age ; Medical treatment ; Pediatrics ; Platelets ; Statistical analysis ; Steroid hormones ; Surgery
  • Is Part Of: Archives of disease in childhood, 2021-10, Vol.106 (Suppl 1), p.A215-A215
  • Description: BackgroundPrevious research has suggested that platelet count could be important in patent ductus arteriosus (PDA) presence1 and possibly closure.2 ObjectivesTo understand the characteristics of patients with a PDA, and identify if platelet count at the start of medical treatment for PDA is a predictor of failure of treatment and need for surgical ligation.MethodsWe reviewed all babies from our unit who had medical or surgical treatment for a PDA over a 1-year period (1st April 2019 - 31st March 2020). This was a retrospective review of the BadgerNet database and clinical notes.ResultsWe identified 26 babies who underwent successful medical treatment, and 6 babies who required a surgical ligation. This analysis excluded a baby with PDA/VSD where data was incomplete. Table 1 shows a comparison of the two groups. Those who had successful medical treatment had greater median gestational age (27 vs 25+4 weeks) and higher birthweight (888grams vs 605grams, p <0.05). More male babies required ligation (n= 5, 83% male), but this was not statistically significant. There were no statistical differences in antenatal steroid administration or in timing of first course of medical treatment (median 5 vs 4.5 days respectively). We also reviewed platelet count at the start of first medical treatment. The platelet count was significantly higher in the group who had successful medical treatment compared to those who went on to surgical ligation (median of 235 vs 119, p <0.05).Abstract 1071 Table 1Comparison of surgical ligation and successful medical treatment Surgical Ligation Successful Medical Treatment Statistical Variable Range Median Range Median Significance Gestation at birth (Weeks+Days) 23+2 - 27+6 25+4 23+2 - 30+0 27+0.5 NA Birthweight (Kg) 0.485–1.053 0.605 0.600–1.462 0.888 **p=0.009 Number Percentage Number Percentage NA Gender Female 1 16.7 10 38.5 p=0.424 Male 5 83.3 16 61.5 NA Antenatal Steroids Complete 6 100 19 73.1 p=0.322 Incomplete 0 0 4 15.4 NA None 0 0 3 11.5 NA Range Median Range Median (Medical Treatment vs Ligation) Median Age at First Medical Treatment (days) 3–16 4.5 2–21 5 p=0.386 Platelet Count at First Medical Treatment (109/L) 43–277 119 89–536 235 *p=0.043 ConclusionsPrevious research has found that low platelet count during medical treatment is associated with failed medical treatment.2 Our findings differ: Platelet count at the start of treatment was associated with failed medical treatment and requirement for PDA ligation. Other characteristics of babies who required surgery for a PDA were observed. On average they were male, 25+4 weeks gestation at birth and 604 grams in birthweight. Could we avoid exposing these babies to the risks and delays of medical treatment and do surgery more directly? These data are also useful for counselling parents and managing expectations of clinicians. Further research into this group specifically and may highlight a more tailored medical treatment strategy that might be successful.ReferencesDizdar EA, Ozdemir R, Sari, FN, et al. Early Human Development 2012;88:813–6.Sallmon H, Weber, SC, Dirks J, et al. Frontiers in Pediatrics 2018;6:41.
  • Publisher: London: BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
  • Language: English
  • Identifier: ISSN: 0003-9888
    EISSN: 1468-2044
    DOI: 10.1136/archdischild-2021-rcpch.375
  • Source: Alma/SFX Local Collection
    ProQuest Central
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