PMID- 25144157
OWN - NLM
STAT- MEDLINE
DCOM- 20150612
LR  - 20211021
IS  - 1476-5543 (Electronic)
IS  - 0743-8346 (Linking)
VI  - 34
IP  - 10
DP  - 2014 Oct
TI  - Short-term outcomes for preterm infants with surgical necrotizing enterocolitis.
PG  - 736-40
LID - 10.1038/jp.2014.153 [doi]
AB  - OBJECTIVE: To characterize the population and short-term outcomes in preterm 
      infants with surgical necrotizing enterocolitis (NEC). STUDY DESIGN: 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.
FAU - Murthy, K
AU  - Murthy K
AD  - Ann & Robert H. Lurie Children's Hospital of Chicago and the Department of 
      Pediatrics, Feinberg School of Medicine, Northwestern University Chicago, 
      Chicago, IL, USA.
FAU - Yanowitz, T D
AU  - Yanowitz TD
AD  - Children's Hospital of Pittsburgh and the Department of Pediatrics, University of 
      Pittsburgh School of Medicine, Pittsburgh, PA, USA.
FAU - DiGeronimo, R
AU  - DiGeronimo R
AD  - Department of Pediatrics, University of Utah and the Primary Childrens Medical 
      Center, Salt Lake City, UT, USA.
FAU - Dykes, F D
AU  - Dykes FD
AD  - Children's Healthcare of Atlanta at Egleston and the Department of Pediatrics, 
      Emory University School of Medicine, Atlanta, GA, USA.
FAU - Zaniletti, I
AU  - Zaniletti I
AD  - Children's Hospital Association, Inc., Overland Park, KS, USA.
FAU - Sharma, J
AU  - Sharma J
AD  - Children's Mercy Hospitals & Clinics, Department of Pediatrics, University of 
      Missouri Kansas City School of Medicine, Kansas City, MO, USA.
FAU - Sullivan, K M
AU  - Sullivan KM
AD  - 1] Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA [2] 
      Department of Pediatrics, Thomas Jefferson University, Philadelphia, PA, USA.
FAU - Mirpuri, J
AU  - Mirpuri J
AD  - Children's Medical Center and the Department of Pediatrics, University of 
      Texas-Southwestern Medical Center, Dallas, TX, USA.
FAU - Evans, J R
AU  - Evans JR
AD  - Children's Hospital of Philadelphia and the Department of Pediatrics, Perelman 
      School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
FAU - Wadhawan, R
AU  - Wadhawan R
AD  - Department of Pediatrics, University of South Florida and the Florida Hospital 
      for Children, Orlando, FL, USA.
FAU - Piazza, A
AU  - Piazza A
AD  - Children's Healthcare of Atlanta at Egleston and the Department of Pediatrics, 
      Emory University School of Medicine, Atlanta, GA, USA.
FAU - Adams-Chapman, I
AU  - Adams-Chapman I
AD  - Children's Healthcare of Atlanta at Egleston and the Department of Pediatrics, 
      Emory University School of Medicine, Atlanta, GA, USA.
FAU - Asselin, J M
AU  - Asselin JM
AD  - Department of Pediatrics, Children's Hospital Oakland & Research Center, 
      Neonatal/Pediatric Research, Oakland, CA, USA.
FAU - Short, B L
AU  - Short BL
AD  - Children's National Medical Center and the Department of Pediatrics, George 
      Washington University School of Medicine, Washington, DC, USA.
FAU - Padula, M A
AU  - Padula MA
AD  - Children's Hospital of Philadelphia and the Department of Pediatrics, Perelman 
      School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
FAU - Durand, D J
AU  - Durand DJ
AD  - Department of Pediatrics, Children's Hospital Oakland & Research Center, Oakland, 
      CA, USA.
FAU - Pallotto, E K
AU  - Pallotto EK
AD  - Children's Mercy Hospitals & Clinics, Department of Pediatrics, University of 
      Missouri Kansas City School of Medicine, Kansas City, MO, USA.
FAU - Reber, K M
AU  - Reber KM
AD  - Nationwide Children's Hospital and the Department of Pediatrics at The Ohio State 
      University College of Medicine, Columbus, OH, USA.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20140821
PL  - United States
TA  - J Perinatol
JT  - Journal of perinatology : official journal of the California Perinatal 
      Association
JID - 8501884
SB  - IM
CIN - J Perinatol. 2014 Oct;34(10):731. PMID: 25263724
MH  - Cause of Death
MH  - Cohort Studies
MH  - Databases, Factual
MH  - Digestive System Surgical Procedures/methods/mortality
MH  - Enterocolitis, Necrotizing/diagnosis/*mortality/*surgery
MH  - Female
MH  - Follow-Up Studies
MH  - *Hospital Mortality
MH  - Hospitals, Pediatric
MH  - Humans
MH  - Infant, Newborn
MH  - *Infant, Premature
MH  - Intensive Care Units, Neonatal
MH  - Male
MH  - Referral and Consultation/statistics & numerical data
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Severity of Illness Index
MH  - Survival Rate
MH  - Time Factors
MH  - Treatment Outcome
MH  - United States
EDAT- 2014/08/22 06:00
MHDA- 2015/06/13 06:00
CRDT- 2014/08/22 06:00
PHST- 2014/07/09 00:00 [received]
PHST- 2014/07/10 00:00 [accepted]
PHST- 2014/08/22 06:00 [entrez]
PHST- 2014/08/22 06:00 [pubmed]
PHST- 2015/06/13 06:00 [medline]
AID - jp2014153 [pii]
AID - 10.1038/jp.2014.153 [doi]
PST - ppublish
SO  - J Perinatol. 2014 Oct;34(10):736-40. doi: 10.1038/jp.2014.153. Epub 2014 Aug 21.