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Clinical determinants of postoperative outcomes in surgical necrotizing enterocolitis

Journal of Perinatology volume 40, pages 1671–1678 (2020)Cite this article

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Abstract

Objective

Investigate predictors of postoperative morbidity and mortality in surgical NEC.

Study design

We analyzed the clinical outcomes of infants with surgical NEC from the years 2000–2015.

Results

Ninety infants born at gestation (mean ± standard deviation, SD; standard error of mean, SEM) 27.3 ± 6.6 weeks (SEM ± 0.07 weeks) and weighing 1008 ± 456 g (SEM ± 48 g) developed NEC on 25.2 ± 22.4 days (SEM ± 2.4 days). Average bowel resection was 29.2 ± 30.5 cm (SEM ± 3.2 cm). Postoperative Ileus lasted 16.5 ± 12.2 days (SEM ± 1.3 days), and was significantly longer in infants with higher gestation and birth weight, age at onset of NEC, length of intestinal resection, maternal chorioamnionitis, and need for pressors. Thirty-eight (42.2%) infants died. Mortality was higher at gestation <31 weeks.

Conclusion

Gestational age, birth weight, age at NEC onset, and length of resected bowel determined postoperative morbidity and mortality in NEC. Length of hospital stay was affected by above factors, and also the duration of postoperative ileus and parenteral nutrition.

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Fig. 1: Kaplan–Meier curve shows gestational age (weeks) plotted against mortality (percentage).

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Funding

National Institutes of Health awards HL124078 and HL133022 to AM Category of study: Clinical science.

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Authors and Affiliations

  1. Department of Pediatrics/Neonatology, University of Mississippi Medical Center, Jackson, MS, USA

    Parvesh M. Garg & Mary M. Hitt

  2. Department of Data Science, University of Mississippi Medical Center, Jackson, MS, USA

    Chad Blackshear

  3. Department of Pediatrics/Neonatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Akhil Maheshwari

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  1. Parvesh M. Garg
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PMG and AM designed the study and wrote the manuscript, MH and CB collected data and did data analysis. All the authors contributed to and approved the manuscript.

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Correspondence to Parvesh M. Garg or Akhil Maheshwari.

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Garg, P.M., Hitt, M.M., Blackshear, C. et al. Clinical determinants of postoperative outcomes in surgical necrotizing enterocolitis. J Perinatol 40, 1671–1678 (2020). https://doi.org/10.1038/s41372-020-0728-8

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