Initial surgery for spontaneous intestinal perforation in extremely low birth weight infants is not associated with mortality or in-hospital morbidities.

Autor: Hair AB; Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA. abhair@texaschildrens.org., Sullivan KM; Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.; Nemours Children's Hospital, Wilmington, DE, USA., Ahmad I; Children's Hospital of Orange County, Orange, CA, USA., Zaniletti I; Children's Hospitals Association, Lenexa, KS, USA., Acker SN; University of Colorado, Children's Hospital of Colorado, Aurora, CO, USA., Premkumar MH; Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA., Reber K; Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA., Huff KA; Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, IN, USA., Nayak SP; University of Texas Southwestern Medical Center, Dallas, TX, USA., DiGeronimo R; Seattle Children's Hospital, University of Washington, Seattle, WA, USA., Kim J; Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA., Roberts J; Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA., Markel TA; Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, IN, USA., Brozanski B; Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, MO, USA., Sharma J; Missouri University of Missouri Kansas City School of Medicine, Children's Mercy Hospital, Kansas City, MO, USA., Piazza AJ; Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA., Yanowitz TD; University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
Jazyk: angličtina
Zdroj: Journal of perinatology : official journal of the California Perinatal Association [J Perinatol] 2024 Dec; Vol. 44 (12), pp. 1746-1754. Date of Electronic Publication: 2024 Jul 12.
DOI: 10.1038/s41372-024-02037-8
Abstrakt: Objective: Determine short-term outcomes following peritoneal drain (PD), laparotomy (LAP) after PD (PD-LAP), and LAP in extremely low birth weight (ELBW) infants with spontaneous intestinal perforation (SIP).
Study Design: ELBW infants with SIP were identified using the Children's Hospitals Neonatal Database. Mortality and length of stay (LOS) were compared among groups.
Results: Of 729 SIP infants from 6/2010-12/2016, 383(53%) received PD, 61(8%) PD-LAP, and 285(39%) LAP. PD infants had lower GA at birth, at SIP diagnosis and upon admission than PD-LAP or LAP; and higher sepsis rates than LAP. Bivariate analysis and Kaplan-Meier survival estimates suggested PD had increased mortality vs. PD-LAP and LAP (27%, 11.5%, and 15.8% respectively, p < 0.001). However, surgical approach was not significantly associated with mortality in multivariable analysis accounting for GA and illness severity. LOS did not differ by surgical approach.
Conclusions: In ELBW infants with SIP, mortality, and LOS are independent of the initial surgical approach.
Competing Interests: Competing interests: The authors declare no competing interests. Ethics: IRB approval was obtained at each participating site prior to entering data into CHND. For analysis of de-identified data, the Stanley Manne Research Center (2011-14673) reviewed and approved this work. The study was performed in accordance with the Declaration of Helsinki.
(© 2024. The Author(s), under exclusive licence to Springer Nature America, Inc.)
Databáze: MEDLINE
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