Short-term outcomes for preterm infants with surgical necrotizing enterocolitis.
J Perinatol
; 34(10): 736-40, 2014 Oct.
Article
en En
| MEDLINE
| ID: mdl-25144157
ABSTRACT
OBJECTIVE:
To characterize the population and short-term outcomes in preterm infants with surgical necrotizing enterocolitis (NEC). STUDYDESIGN:
Preterm infants with surgical NEC were identified from 27 hospitals over 3 years using the Children's Hospitals Neonatal Database; infants with gastroschisis, volvulus, major congenital heart disease or surgical NEC that resolved prior to referral were excluded. Patient characteristics and pre-discharge morbidities were stratified by gestational age (<28 vs 28(0/7) to 36(6/7) weeks' gestation).RESULT:
Of the 753 eligible infants, 60% were born at <28 weeks' gestation. The median age at referral was 14 days; only 2 infants were inborn. Male gender (61%) was overrepresented, whereas antenatal steroid exposure was low (46%). Although only 11% had NEC totalis, hospital mortality (<28 weeks' gestation 41%; 28(0/7) to 36(6/7) weeks' gestation 32%, P=0.02), short bowel syndrome (SBS)/intestinal failure (IF) (20% vs 26%, P=0.06) and the composite of mortality or SBS/IF (50% vs 49%, P=0.7) were prevalent. Also, white matter injury (11.7% vs 6.6%, P=0.02) and grade 3 to 4 intraventricular hemorrhages (23% vs 2.7%, P<0.01) were commonly diagnosed. After referral, the median length of hospitalization was longer for survivors (106 days; interquartile range (IQR) 79, 152) relative to non-survivors (2 days; IQR 1,17; P<0.001). These survivors were prescribed parenteral nutrition infrequently after hospital discharge (<28 weeks' 5.2%; 28(0/7) to 36(6/7) weeks' 9.9%, P=0.048).CONCLUSION:
After referral for surgical NEC, the short-term outcomes are grave, particularly for infants born <28 weeks' gestation. Although analyses to predict outcomes are urgently needed, these data suggest that affected infants are at a high risk for lengthy hospitalizations and adverse medical and neuro-developmental abnormalities.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Recien Nacido Prematuro
/
Mortalidad Hospitalaria
/
Enterocolitis Necrotizante
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Male
/
Newborn
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Perinatol
Asunto de la revista:
PERINATOLOGIA
Año:
2014
Tipo del documento:
Article
País de afiliación:
Estados Unidos