Dynamic and visual nomograms to online predict unfavorable outcome of mechanical thrombectomy for acute basilar artery occlusion

BACKGROUND

The evidence of mechanical thrombectomy (MT) in basilar artery occlusion (BAO) was limited. This study aimed to develop dynamic and visual nomogram models to predict the unfavorable outcome of MT in BAO online.

METHODS

BAO patients treated with MT were screened. Preoperative and postoperative nomogram models were developed based on clinical parameters and imaging features. An independent dataset was collected to perform external validation. Web-based calculators were constructed to provide convenient access.

RESULTS

A total of 127 patients were included in the study, and 117 of them were eventually included in the analysis. The nomogram models showed robust discrimination, with an area under the receiver operating characteristic (ROC) of 0.841 (preoperative) and 0.916 (postoperative). The calibration curves showed good agreement. The preoperative predictors of an unfavorable outcome were previous stroke, the National Institutes of Health Stroke Scale (NIHSS) at admission, and the posterior circulation Alberta Stroke Program Early Computed Tomography Score (pc-ASPECTS). The postoperative predictors were previous stroke, NIHSS at 24 h, and pc-ASPECTS.

CONCLUSION

Dynamic and visual nomograms were constructed and validated for the first time for BAO patients treated with MT, which provided precise predictions for the risk of an unfavorable outcome. The preoperative model may assist clinicians in selecting eligible patients, and the postoperative model may facilitate individualized poststroke management.

[Features of the course and adverse events risk of coronavirus infection COVID-19 in hematological diseases (data from the CHRONOS19 register for the Primorsky Territory, intermediate stage)]

AIM

To assess the characteristics of the course of coronavirus infection COVID-19 and to determine the risk factors for adverse events in patients of the regional hematological center.

MATERIALS AND METHODS

As part of an observational prospective cohort study, data from 144 medical records of patients in Primorsky Krai with hematological diseases and COVID-19 were analyzed. The data of the developed standardized questionnaire of the CHRONOS19 study were used. The primary endpoint (adverse outcome) was a composite point that included mortality from any cause during the observation period, development of acute respiratory distress syndrome, hospitalization in the intensive care unit, and the need for mechanical ventilation.

RESULTS

A study of the features of the course of COVID-19 in hematological patients showed an increase in the number of adverse events in patients with neoplastic blood diseases, especially in chronic lymphoproliferative diseases and acute myeloid leukemia. Significant predictors of an unfavorable course of COVID-19 include a refractory/recurrent variant of the course of a blood tumor, glucocorticoid therapy as part of the protocol for the treatment of the underlying disease, stage 3-4 lung damage according to computerised tomography scans at the onset of COVID-19, and the presence of diabetes mellitus.

CONCLUSION

Predictors of an unfavorable course of COVID-19 in hematological patients have been identified. Hematological patients in the context of the COVID-19 pandemic require a coordinated interdisciplinary approach involving hematologists and therapists, careful monitoring of clinical and laboratory parameters to reduce the risk of adverse events.

Prevalence of unfavorable outcome in acute poisoning and associated factors at the University of Gondar comprehensive specialized hospital, Gondar, Northwest Ethiopia: a hospital-based cross-sectional study

Background

Acute poisoning is a medical emergency in which the toxic effects occur almost immediately, usually within hours from the time of exposure, and can result from exposure to excessive doses of any chemical. It is the common cause of emergency admission, which may result in morbidity and mortality. There are a lot of factors that are associated with an increased magnitude of mortality and complication. Therefore, this study was carried out to assess the clinical characteristics of patients, unfavorable outcomes of acute poisoning, and associated factors to improve the quality of care, resource utilization, and decrease mortality.

Objective

This study aimed to assess the outcome and associated factors among acute poisoning patients at the University of Gondar Comprehensive Specialized Hospital, Gondar, Northwest Ethiopia (2021).

Methods

A prospective follow-up study was conducted from January 2021 to September 2021 at the University of Gondar Comprehensive Specialized Hospital, Gondar, Northwest Ethiopia. Data were collected using a comprehensively organized and pretested interviewer-administered questionnaire. The data were entered using EPI data version 4.6.0 statistical software and then exported to Stata 14 for analysis. The data were analyzed for descriptive statistics. Statistical analysis was performed using bivariate and multivariate logistic regression models to identify factors associated with the unfavorable outcome of acute poisoning. The result is presented in the form of tables, figures, and text using frequencies and summary statistics such as mean, SD, median, IQR, and percentage.

Result

A total of 233 patients were included in the study. The prevalence of unfavorable poisoning outcomes in acute poisoning was 17.6% (95% CI: 13.2, 23.1). In the multivariate logistic regression analysis, known chronic medical comorbidities [AOR: 3.846 (1.619, 9.574); value of p: 0.014] and hospital stay of less than 48 h [AOR: 6.57 (2.03, 21.273); value of p: 0.002] were found to be independent factors associated with unfavorable outcomes in acute poisoning.

Conclusion

The magnitude of unfavorable poisoning outcomes was high in patients with acute poisoning. Having known medical comorbid illness and short hospital stay of less than 48 h were found to be associated with unfavorable outcomes.

Outcomes and Predictors of Severe Community-acquired Pneumonia Among Adults Admitted to the University of Gondar Comprehensive Specialized Hospital: A Prospective Follow-up Study

Background

Severe community-acquired pneumonia is a common life-threatening infection with a high rate of unfavorable outcome. This study aimed to assess the outcomes and predictors of hospitalized severe community-acquired pneumonia patients at University of Gondar comprehensive specialized hospital.

Methods

A prospective follow-up study was conducted at University of Gondar comprehensive specialized hospital from May 1 to September 31, 2021. The data was collected by reviewing patients' charts and interviewing the patients themselves. Descriptive statistics, binary and multivariable logistic regression analysis were performed accordingly. Variables with p-value <0.2 on binary logistic regression were analyzed using multivariable logistic regression and variables with p<0.05 were considered to have significant association.

Results

A total of 239 admitted patients with severe community-acquired pneumonia were enrolled in the study. An unfavorable outcome was observed in 105 (44%) patients; 24.27% was in-hospital all-cause mortality, 12.5% was nonresolution, 5.8% was complicated cases, and 1.26% were gone against medical care for poor prognosis. After analyzing multivariable logistic regression, confusion (OR= 4.84; 95%CI: 1.47-15.88), anemia (OR= 2.36; 95%CI: 1.01-5.52), leukopenia (OR=4.38; 95%CI: 1.26-15.25), leukocytosis (OR=3.15; 95%CI: 1.23-7.96), elevated creatinine (OR=5.67; 95%CI: 1.72-18.65), intubation (OR=7.27; 95%CI: 1.58-33.37) and antibiotic revision during treatment for a different reason (OR=0.02; 95%CI: 0.01-0.07) were variables significantly associated with unfavorable outcome.

Conclusion

Unfavorable outcome was high among hospitalized severe community acquired pneumonia patients, and confusion, elevated creatinine, anemia, leukopenia, leukocytosis, intubation during admission, and antibiotic revision during the course were independent predictors associated significantly with the unfavorable outcome. It is important to consider the development of a treatment protocol for the hospital and to further research incorporating the microbiologic profile of the patients.

A novel visual dynamic nomogram to online predict the risk of unfavorable outcome in elderly aSAH patients after endovascular coiling: A retrospective study

Background

Aneurysmal subarachnoid hemorrhage (aSAH) is a significant cause of morbidity and mortality throughout the world. Dynamic nomogram to predict the prognosis of elderly aSAH patients after endovascular coiling has not been reported. Thus, we aimed to develop a clinically useful dynamic nomogram to predict the risk of 6-month unfavorable outcome in elderly aSAH patients after endovascular coiling.

Methods

We conducted a retrospective study including 209 elderly patients admitted to the People's Hospital of Hunan Province for aSAH from January 2016 to June 2021. The main outcome measure was 6-month unfavorable outcome (mRS ≥ 3). We used multivariable logistic regression analysis and forwarded stepwise regression to select variables to generate the nomogram. We assessed the discriminative performance using the area under the curve (AUC) of receiver-operating characteristic and the risk prediction model's calibration using the Hosmer-Lemeshow goodness-of-fit test. The decision curve analysis (DCA) and the clinical impact curve (CIC) were used to measure the clinical utility of the nomogram.

Results

The cohort's median age was 70 (interquartile range: 68-74) years and 133 (36.4%) had unfavorable outcomes. Age, using a ventilator, white blood cell count, and complicated with cerebral infarction were predictors of 6-month unfavorable outcome. The AUC of the nomogram was 0.882 and the Hosmer-Lemeshow goodness-of-fit test showed good calibration of the nomogram (p = 0.3717). Besides, the excellent clinical utility and applicability of the nomogram had been indicated by DCA and CIC. The eventual value of unfavorable outcome risk could be calculated through the dynamic nomogram.

Conclusion

This study is the first visual dynamic online nomogram that accurately predicts the risk of 6-month unfavorable outcome in elderly aSAH patients after endovascular coiling. Clinicians can effectively improve interventions by taking targeted interventions based on the scores of different items on the nomogram for each variable.

Persistent dysglycemia is associated with unfavorable treatment outcomes in patients with pulmonary tuberculosis from Peru

BACKGROUND

Dysglycemia (i.e., prediabetes or diabetes) on patients with tuberculosis (PWTB) was associated with increased odds of mortality and treatment failure. Whether such association holds when dysglycemia is transient or persistent is unknown. Here we tested the association between persistent dysglycemia (PD) during anti-TB treatment and unfavorable treatment outcomes in PWTB from Lima, Peru.

METHODS

PWTB enrolled between February and November 2017 were followed for 24-months. Dysglycemia was measured by fasting glucose and HbA1c at baseline, 2^nd-and 6^th-month of TB treatment. PD was defined as dysglycemia detected in two different visits. The association between PD and unfavorable TB treatment outcome was evaluated by logistic regression.

RESULTS

Among 125 PWTB, PD prevalence was 29.6%. PD was associated with more lung lesion types, higher bacillary loads, low hemoglobin and high body mass index (BMI). Unfavorable TB treatment outcome was associated with older age, higher BMI, more lung lesion types and PD. After adjusting for age, hemoglobin levels, smoking and smear grade, PD was independently associated with unfavorable treatment (aOR: 6.1; 95%CI: 1.9-19.6).

CONCLUSION

Persistent dysglycemia is significantly associated with higher odds of unfavorable TB treatment outcomes. Dysglycemia control trough anti-TB treatment gives the opportunity to introduce appropriate interventions to TB management.

Characteristics and Outcomes of Intravenous Thrombolysis in Mild Ischemic Stroke Patients

Objective: This study assessed the characteristics of intravenous thrombolysis (IVT) with respect to early neurological deterioration (END) and functional outcome in mild ischemic stroke patients.

Methods: Data were obtained from acute mild ischemic stroke patients (defined as having a National Institute of Health Stroke Score (NIHSS) ≤ 5) treated with IVT in our hospital from July 2017 to December 2020. END was defined as the NIHSS increased ≥1 over the baseline at 24 h after IVT. A modified Rankin scale (mRS) ≤ 1 at 3 months was considered as a favorable outcome, and an mRS ≥2 at 3 months was an unfavorable outcome.

Results: Two hundred thirty-three acute mild ischemic stroke patients (all patients underwent MRI and DWI restriction) with IVT were included in this study. Thirty-one patients experienced END, and 57 patients experienced an unfavorable outcome at 3 months. With multivariate analysis, END was associated with an elevated baseline systolic blood pressure (SBP) (OR = 1.324, 95% CI, 1.053–1.664, p = 0.016) and coronary heart disease (OR = 4.933, 95% CI, 1.249–19.482, p = 0.023). An unfavorable outcome at 3 months after IVT was independently associated with a baseline elevated SBP (OR = 1.213, 95% CI, 1.005–1.465, p = 0.045), baseline NIHSS (OR = 1.515, 95% CI, 1.186–1.935, p = 0.001), prior hyperlipemia (OR = 3.065, 95% CI, 1.107–8.482, p = 0.031), cardioembolic stroke (OR = 0.323, 95% CI, 0.120–0.871, p = 0.025), and END at 24 h (OR = 4.531, 95% CI, 1.950–10.533, p < 0.001) in mild ischemic stroke patients.

Conclusion: In mild ischemic stroke patients with IVT, an elevated baseline SBP and coronary heart disease were associated with END. The elevated baseline SBP, baseline NIHSS, a history of prior hyperlipemia, cardioembolic stroke, and END at 24 h after IVT were useful in predicting an unfavorable outcome at 3 months.

Quantitative assessment of SARS-CoV-2 RNAemia and outcome in patients with coronavirus disease 2019

The disease spectrum of coronavirus disease 2019 (COVID‐19) varies from asymptomatic infection to critical illness and death. Identification of prognostic markers is vital for predicting progression and clinical practice. Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) RNA, known as RNAemia, has been detected in the blood. However, the potential clinical value of SARS‐CoV‐2 RNAemia remains unknown. We, therefore, conducted a meta‐analysis using a random‐effects model to estimate the pooled prevalence of SARS‐CoV‐2 RNAemia as well as summary strength of RNAemia in association with disease severity and unfavorable clinical outcomes. A total of 21 studies involving 2181 patients were included. SARS‐CoV‐2 RNAemia in COVID‐19 patients varied from 9.4% to 74.1%, with a pooled estimate of 34% (95% confidene interval [CI]: 26%–43%). Overall, SARS‐CoV‐2 RNAemia was associated with COVID‐19 severity with odds ratio (OR) of 5.43 (95% CI: 3.46–8.53). In addition, SARS‐CoV‐2 RNAemia was a significant risk factor for unfavorable clinical outcomes (OR = 6.54, 95% CI: 3.82–11.21). The summary OR was 4.28 (95% CI: 2.20–8.33) for intensive care unit (ICU) admission, 11.07 (95% CI: 5.60–21.88) for mortality. Furthermore, RNAemia was also a significant risk factor for invasive mechanical ventilation and multiple organ failure. SARS‐CoV‐2 RNAemia is associated with disease severity, ICU admission, death in COVID‐19, and may serve as a clinical predictor. More prospective trials in evaluating the potential of SARS‐CoV‐2 RNAemia as a prognostic indicator are necessary.

Association of a High Neutrophil-to-Lymphocyte Ratio with Hyperdense Artery Sign and Unfavorable Short-Term Outcomes in Patients with Acute Ischemic Stroke

Purpose

Immune–inflammatory processes are involved in all the stages of stroke. This study investigated the association of the neutrophil-to-lymphocyte ratio (NLR) with the hyperdense artery sign (HAS) observed on brain computed tomography (CT) and with clinical features in patients with acute ischemic stroke.

Methods

We retrospectively enrolled 2903 inpatients with acute ischemic stroke from May 2010 to May 2019. Data collected included imaging studies, risk factors, laboratory parameters, and clinical features during hospitalization.

Results

The HAS was identified in 6% of the 2903 patients and 66% of the 236 patients with acute middle cerebral artery occlusion. Patients with the HAS had a higher NLR. HAS prevalence was higher in men and patients with cardioembolism. The NLR exhibited positive linear correlations with age, glucose and creatinine levels, length of hospital stay, initial National Institutes of Health Stroke Scale (NIHSS) scores, and mRS scores at discharge. The NLR was significantly higher in patients with large-artery atherosclerosis and cardioembolism and was the highest in patients with other determined etiology. Multivariate analysis revealed that an initial NIHSS score of ≥10 and an NLR of >3.5 were significant positive factors, whereas diabetes mellitus and age > 72 years were significant negative factors for the HAS, with a predictive performance of 0.893. An initial NIHSS score of ≥5, positive HAS, age > 75 years, diabetes mellitus, an NLR of >3.5, female sex, a white blood cell count of >8 × 10³/mL, and elevated troponin I were significant predictors of unfavorable outcomes, with a predictive performance of 0.886.

Conclusion

An NLR of >3.5 enabled an efficient prediction of CT HAS. In addition to conventional risk factors and laboratory parameters, both an NLR of >3.5 and CT HAS enabled improved prediction of unfavorable stroke outcomes.

Predicting 6-Month Unfavorable Outcome of Acute Ischemic Stroke Using Machine Learning

Background and Purpose: Accurate prediction of functional outcome after stroke would provide evidence for reasonable post-stroke management. This study aimed to develop a machine learning-based prediction model for 6-month unfavorable functional outcome in Chinese acute ischemic stroke (AIS) patient. Methods: We collected AIS patients at National Advanced Stroke Center of Nanjing First Hospital (China) between September 2016 and March 2019. The unfavorable outcome was defined as modified Rankin Scale score (mRS) 3-6 at 6-month. We developed five machine-learning models (logistic regression, support vector machine, random forest classifier, extreme gradient boosting, and fully-connected deep neural network) and assessed the discriminative performance by the area under the receiver-operating characteristic curve. We also compared them to the Houston Intra-arterial Recanalization Therapy (HIAT) score, the Totaled Health Risks in Vascular Events (THRIVE) score, and the NADE nomogram. Results: A total of 1,735 patients were included into this study, and 541 (31.2%) of them had unfavorable outcomes. Incorporating age, National Institutes of Health Stroke Scale score at admission, premorbid mRS, fasting blood glucose, and creatinine, there were similar predictive performance between our machine-learning models, while they are significantly better than HIAT score, THRIVE score, and NADE nomogram. Conclusions: Compared with the HIAT score, the THRIVE score, and the NADE nomogram, the RFC model can improve the prediction of 6-month outcome in Chinese AIS patients.

A NAC nomogram to predict the probability of three-month unfavorable outcome in Chinese acute ischemic stroke patients treated with mechanical thrombectomy

BACKGROUND AND PURPOSE

Mechanical thrombectomy (MT) is a standard care for most acute ischemic stroke (AIS) patients. For AIS patients underwent MT, predicting the patients at high risk of unfavorable outcome and adjusting therapeutic strategies accordingly can greatly improve patient outcomes. We aimed to develop and validate a nomogram for individualized prediction of Chinese AIS patients underwent MT.

METHODS

We conducted a multicenter prospective study including 238 AIS patients who underwent MT from January 2014 to December 2018. The main outcome measure was three-month unfavorable outcome (modified Rankin Scale 3-6). A nomogram was generated based on multivariate logistic model. We assessed the discriminative performance by using the area under the receiver-operating characteristic curve and calibration of risk prediction model by using the Hosmer-Lemeshow test.

RESULTS

In NAC nomogram, NIHSS (National Institutes of Health Stroke Scale) score on admission (OR: 1.193, p < 0.0001), Age (OR: 1.025, p = 0.037) and Creatinine (OR: 1.028, p < 0.0001) remained independent predictors of 3-month unfavorable outcome in Chinese AIS patients treated with MT. The NAC nomogram exhibited an area under the curve of 0.816 for predicting functional impairment. Calibration was good (p = 0.560 for the Hosmer-Lemeshow test).

CONCLUSIONS

The NAC nomogram is the first nomogram developed and validated in Chinese AIS patients treated with MT and it may be used to predict 3 months unfavorable outcome for these patients.

Prominent FLAIR Vascular Hyperintensity Is a Predictor of Unfavorable Outcomes in Non-thrombolysed Ischemic Stroke Patients With Mild Symptoms and Large Artery Occlusion

Background and objective: The aim was to evaluate the clinical significance of prominent fluid-attenuated inversion recovery (FLAIR) vascular hyperintensity (FVH) on the prognosis of mild acute ischemic stroke with middle cerebral artery (MCA) occlusion.

Methods: We recruited consecutive stroke patients with initial National Institutes of Health Stroke Scale (NIHSS) scores ≤5 and MCA occlusion on magnetic resonance angiography within 24 h of stroke onset. Prominent distal FVH was defined as an extension to more than one-third of the MCA territory. We compared clinical outcomes between prominent and non-prominent FVH groups in patients who had and had not received reperfusion therapy.

Results: Of 112 participants [43 women; median age, 67 years [Interquartile range, 54–79]], prominent FVH was identified in 80 (71.4%). For 75 patients who had not received reperfusion therapy, the prominent FVH group had a more unfavorable outcome (modified Rankin Scale score >1) at 3 months than the non-prominent FVH group (44.4 vs. 15.0%, P = 0.029). In multivariate analysis, a higher NIHSS score [odd ratio [OR] = 1.67; 95% confidence interval [CI], 1.16–2.41; P = 0.006], proximal MCA occlusion [OR = 7.31; 95% CI, 1.68–31.9; P = 0.008], and prominent FVH [OR = 5.49; 95% CI, 1.29–23.4; P = 0.021], were independently associated with an unfavorable outcome. There was no association between prominent FVH and the clinical outcome in the reperfusion therapy group.

Conclusions: For acute stroke patients with mild symptoms and MCA occlusion who do not receive reperfusion therapy, prominent FVH and proximal MCA occlusion may be independent predictors of an unfavorable outcome.

Tumor-infiltrating tryptase+ mast cells predict unfavorable clinical outcome in solid tumors

The prognostic role of tumor-infiltrating tryptase⁺ mast cells in human solid tumors remains controversial. Herein, we conducted a meta-analysis including 28 published studies with 4224 patients identified from PubMed and EBSCO to assess the prognostic impact of tumor-infiltrating tryptase⁺ mast cells in human solid tumors. We found that tryptase⁺ mast cell infiltration significantly decreased overall survival (OS) and disease-free survival (DFS) in all types of solid tumors. In stratified analyses, tryptase⁺ mast cell infiltration was significantly associated with worse OS in non-small cell lung cancer, hepatocellular carcinoma and 5-year survival in colorectal cancer. And these cells were inversely associated with DFS in hepatocellular and colorectal cancer. In addition, high density of intratumoral tryptase⁺ mast cells significantly correlated with lymph node metastasis of solid tumor. In conclusion, Tryptase⁺ mast cell infiltration leads to an unfavorable clinical outcome in solid tumors, implicating that it is a valuable biomarker for prognostic prediction for human solid malignances and targeting it may have a potential for effective treatment.

Anemia is an independent prognostic factor in intracerebral hemorrhage: an observational cohort study

INTRODUCTION

To date only two studies have evaluated anemia status in acute intracerebral hemorrhage (ICH) reporting that on admission anemia (OAA) was associated with larger hematoma volume, and lower hemoglobin levels during hospital stay, which related to poorer outcome. The question remains whether anemia influences outcome through related volume-effects or itself has an independent impact?

METHODS

This single-center investigation included 435 consecutive patients with spontaneous ICH admitted to the Department of Neurology over five years. Functional short- and long-term outcome (3 months and 1 year) were analyzed for anemia status. Multivariate logistic and graphical regression analyses were calculated for associations of anemia and to determine independent effects on functional outcome. It was decided to perform a separate analysis for patients with ICH-volume <30 cm³ (minor-volume-ICH).

RESULTS

Overall short-term-outcome was worse in anemic patients (mRS[4-6] OAA = 93.3% vs. non-OAA = 61.2%, P < 0.01), and there was a further shift towards an increased long-term mortality (P = 0.02). The probability of unfavorable long-term-outcome (mRS[4-6]) in OAA was elevated 7-fold (OR:7.5; P < 0.01). Receiver operating characteristics curve (ROC) analysis revealed a positive but poor association of ICH-volume and anemia (AUC = 0.67) suggesting volume-undriven outcome-effects of anemia (AUC = 0.75). Multivariate regression analyses revealed that anemia, besides established parameters, has the strongest relation to unfavorable outcome (OR:3.0; P < 0.01). This is even more pronounced in minor-volume-ICH (OR:5.6; P < 0.01).

CONCLUSIONS

Anemia seems to be a previously unrecognized significant predictor of unfavorable functional outcome with independent effects beyond its association with larger hemorrhage volumes. The recognition of anemia and its treatment may possibly influence outcome after ICH and as such prospective interventional studies are warranted.

Structural and functional results of indirect diode laser treatment for retinopathy of prematurity from 1999 to 2003 in Kuwait

Purpose

The purpose was to report the structural, visual, and refractive outcomes of infants treated for retinopathy of prematurity (ROP) with laser and to identify the risk factors for unfavorable outcomes.

Materials and methods

The charts of infants with severe ROP treated by diode laser in a tertiary center during the period April 1999 to November 2003 were reviewed. Treated infants were followed up for fundus examination, visual acuity assessment, and cycloplegic refraction. Data regarding ocular risk factors, like zones of ROP and the extent of extraretinal proliferations, and data regarding various systemic risk factors were collected. A minimum follow up of 6 months was needed for inclusion in the study of structural outcome. A minimum follow up of 24 months was needed for the study of visual and refractive outcomes. The outcomes measured were: rate of unfavorable structural outcome, unfavorable visual outcome (visual acuity < 20/40), and high myopia (myopia ≥ 5 diopters). The ocular and systemic risk factors were studied for their significance in the development of unfavorable outcomes.

Results

Two hundred seventy eyes of 148 infants were treated for severe ROP, out of which 20 eyes (7.4%) had unfavorable structural outcome. Visual data were available for 149 eyes of 81 infants, of which 70 eyes (47%) had unfavorable visual outcome. Refractive data were available for 131 eyes of 72 infants, and high myopia was present in 23 (17.6%) eyes. Zone I disease was the significant risk factor for unfavorable structural (P < 0.0001), unfavorable visual outcome (P = 0.03), and for high myopia (P < 0.0001). Lower post-conceptional age at treatment was significant for unfavorable structural outcome (P = 0.03) and high myopia (P < 0.0001). Presence of sepsis (P = 0.029) and extraretinal proliferation ≥ 6 hours were significant for unfavorable structural outcome (P = 0.002).

Conclusion

ROP in zone I was the most significant risk factor for all the unfavorable outcomes. Laser-treated ROP infants need long term follow up.