Evaluation and Validation of a Prediction Model for Extubation Success in Very Preterm Infants

Abstract ObjectiveTo evaluate the performance of a publicly available model predicting extubation success in very preterm infants.Study DesignRetrospective study of infants born < 1250 g at a single center. Model performance evaluated using the area under the receiver operating curve (AUROC) and comparing observed and expected probabilities of extubation success, defined as survival ≥ 5 d without an endotracheal tube.ResultsOf 177 infants, 120 (68%) were extubated successfully. The median (IQR) gestational age was 27 weeks (25–28) and weight at extubation was 915 g (755–1050). The model had acceptable discrimination (AUROC 0.72 [95% CI 0.65–0.80]) and adequate calibration (calibration slope 0.96, intercept − 0.06, mean observed-to-expected difference in probability of extubation success − 0.08 [95% CI -0.01, -0.15]).ConclusionsThe extubation success prediction model has acceptable performance in an external cohort, supporting its potential utility in clinical decision-making. Additional studies are needed to determine if its use can improve outcomes.