Perioperative support, not volume, is necessary to optimize outcomes in surgical management of necrotizing enterocolitis.
Am J Surg
; 213(3): 502-506, 2017 Mar.
Article
en En
| MEDLINE
| ID: mdl-27871683
ABSTRACT
BACKGROUND:
This study examines the relationship between hospital volume of surgical cases for necrotizing enterocolitis (NEC) and patient outcomes.METHODS:
A retrospective cross-sectional review was performed using the HCUP SID for California from 2007 to 2011. Patients with NEC who underwent surgery were identified using ICD-9CM codes. Risk-adjusted models were constructed with mixed-effects logistic regression using patient and demographic covariates.RESULTS:
23 hospitals with 618 patients undergoing NEC-related surgical intervention were included. Overall mortality rate was 22.5%. There were no significant differences in the number of NICU beds (p = 0.135) or NICU intensivists (p = 0.469) between high and low volume hospitals. Following risk adjustment, no difference in mortality rate was observed between high and low volume hospitals respectively (24.0% vs. 20.3%, p = 0.555).CONCLUSIONS:
Our observation that neonates with NEC treated at low-volume centers have no increased risk of mortality may be explained by similar availability of NICU and intensivists resources across hospitals.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Enterocolitis Necrotizante
/
Hospitales de Alto Volumen
/
Hospitales de Bajo Volumen
Tipo de estudio:
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Infant
/
Male
/
Newborn
País/Región como asunto:
America do norte
Idioma:
En
Año:
2017
Tipo del documento:
Article