TY - JOUR
T1 - Initial surgery for spontaneous intestinal perforation in extremely low birth weight infants is not associated with mortality or in-hospital morbidities
AU - Children’s Hospitals Neonatal Consortium Necrotizing Enterocolitis Focus Group
AU - Hair, Amy B.
AU - Sullivan, Kevin M.
AU - Ahmad, Irfan
AU - Zaniletti, Isabella
AU - Acker, Shannon N.
AU - Premkumar, Muralidhar H.
AU - Reber, Kristina
AU - Huff, Katie A.
AU - Nayak, Sujir Pritha
AU - DiGeronimo, Robert
AU - Kim, Jae
AU - Roberts, Jessica
AU - Markel, Troy A.
AU - Brozanski, Beverly
AU - Sharma, Jotishna
AU - Piazza, Anthony J.
AU - Yanowitz, Toby D.
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer Nature America, Inc. 2024.
PY - 2024
Y1 - 2024
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85198360369&partnerID=8YFLogxK
U2 - 10.1038/s41372-024-02037-8
DO - 10.1038/s41372-024-02037-8
M3 - Article
C2 - 38992239
AN - SCOPUS:85198360369
SN - 0743-8346
JO - Journal of Perinatology
JF - Journal of Perinatology
ER -