Prediction of Intestinal Perforation by Daily Radiographic Findings in Very Low Birth Weight Infants With Meconium Ileus.

Autor: Katsumata Y; Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan., Terui K; Division of Pediatric Surgery, Department of Surgery, Jichi Medical University, 331-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan. Electronic address: kta@cc.rim.or.jp., Takenouchi A; Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan., Komatsu S; Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan., Kawaguchi Y; Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan., Nishimura K; Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan., Mise N; Department of Pediatric Surgery, Matsudo City General Hospital, 993-1, Sendabori, Matsudo, Chiba, 270-2296, Japan., Matsuura G; Department of Pediatric Surgery, Matsudo City General Hospital, 993-1, Sendabori, Matsudo, Chiba, 270-2296, Japan., Endo M; Department of Pediatrics, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan., Osone Y; Perinatal Medical Center, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan., Sonoda Y; Department of Neonatology, Matsudo City General Hospital, 993-1, Sendabori, Matsudo, Chiba, 270-2296, Japan., Yoshida K; Department of Neonatology, Matsudo City General Hospital, 993-1, Sendabori, Matsudo, Chiba, 270-2296, Japan., Hishiki T; Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan.
Jazyk: angličtina
Zdroj: Journal of pediatric surgery [J Pediatr Surg] 2024 Nov 26; Vol. 60 (2), pp. 162076. Date of Electronic Publication: 2024 Nov 26.
DOI: 10.1016/j.jpedsurg.2024.162076
Abstrakt: Background: This study aimed to develop a prediction model for intestinal perforation from meconium ileus (MI) based on findings from plain X-ray images.
Methods: Very low birth weight (VLBW) infants with MI hospitalized in two tertiary centers between 2011 and 2022 were included in this study. We retrospectively reviewed clinical parameters and assessed plain X-ray images from 0 to 5 days of age. The standardized transverse diameter of intestinal gas (STDI) was calculated by dividing the largest diameter of the intestinal gas by the distance from the upper edge of L1 to the lower edge of L4. We then compared the STDI of patients with and without intestinal perforation.
Results: Among 81 VLBW infants with MI, intestinal perforation occurred in 6 (7 %). Among known risk factors, significant differences were observed between the two groups regarding pregnancy-induced hypertension (p = 0.03), weeks of gestation (p < 0.01), birthweight (p = 0.02), and indomethacin administration (p < 0.01). The mortality rate was higher in the perforation group (33 %) than in the non-perforation group (3 %) (p = 0.021). There were significant differences between the perforated and non-perforated groups regarding STDI except at 0 days of age. The positive and negative predictive cut-off values of STDI were respectively 0.08 and 0.93 on day 0, 0.30 and 1.00 on day 1, 0.33 and 0.97 on day 2, 0.33 and 1.00 on day 3, 0.29 and 1.00 on day 4, and 0.33 and 0.98 on day 5, respectively.
Conclusions: Our novel prediction model, using STDI, predicted intestinal perforation in VLBW infants with MI.
Levels of Evidence: Level Ⅲ.
Competing Interests: Conflicts of interest The authors have no financial conflicts of interest to disclose concerning the study.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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