Document Detail

Does hospital transfer predict mortality in very low birth weight infants requiring surgery for necrotizing enterocolitis?
MedLine Citation:
PMID:  22770955     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Necrotizing enterocolitis (NEC) is a leading cause of infant mortality, and the most common reason for emergent surgery in very low birth weight (VLBW, < 1,500 g) infants. We investigated whether transfer for higher level of surgical care affects mortality in this population.
METHODS: VLBW infants who underwent NEC surgery were reviewed retrospectively from the California Patient Discharge Linked Birth Cohort Database (1999-2007). Transfer for emergent operation was defined as surgery ≤2 days after transfer. Mortality was analyzed with multivariate logistic regression.
RESULTS: Overall, 1,272 VLBW infants with surgical NEC were identified, with a 39% mortality. Transfer for operative care occurred in 406 (32%) infants. Unadjusted mortality was not increased for infants who were transferred compared with not transferred (37% vs. 40%; P = .25). Adjusted mortality for infants transferred for operative care did not differ from those who received operative care at their primary neonatal intensive care unit (odds ratio 0.75, 95% confidence interval 0.42-1.32). Lower birth weight, lack of prenatal care, peritoneal drainage as sole surgical intervention, and pulmonary interstitial emphysema/pulmonary hemorrhage were associated with increased odds of mortality (P < .05).
CONCLUSION: VLBW infants with surgical NEC do not demonstrate increased risk of mortality when transferred emergently for operative care. Future efforts must engage health professionals caring for this vulnerable population to maximize resource allocation and safety.
Lorraine I Kelley-Quon; Chi-Hong Tseng; Andrew Scott; Howard C Jen; Kara L Calkins; Stephen B Shew
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-07-06
Journal Detail:
Title:  Surgery     Volume:  152     ISSN:  1532-7361     ISO Abbreviation:  Surgery     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-03     Completed Date:  2012-11-06     Revised Date:  2013-09-03    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  337-43     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Mosby, Inc. All rights reserved.
Division of Pediatric Surgery-Department of Surgery, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-7098, USA.
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MeSH Terms
Enterocolitis, Necrotizing / mortality*,  surgery*
Infant, Newborn
Infant, Newborn, Diseases / mortality*,  surgery*
Infant, Very Low Birth Weight
Logistic Models
Patient Transfer / statistics & numerical data*
Retrospective Studies
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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