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    
Abstract/OtherAbstract:
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.
Authors:
Lorraine I Kelley-Quon; Chi-Hong Tseng; Andrew Scott; Howard C Jen; Kara L Calkins; Stephen B Shew
Related Documents :
21344795 - Bacterial vaginosis in threatened preterm, preterm and term labour.
11640215 - Marvellous secrets: birth control in european short fiction, 1150-1650.
22709245 - The effectiveness of video interaction guidance in parents of premature infants: a mult...
22138365 - Parental and romantic attachment shapes brain processing of infant cues.
11951995 - Randomized double-blind controlled trial on the effects on iron status in the first yea...
1914155 - Differential effects of neonatal castration on the development of sexually dimorphic br...
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.
Affiliation:
Division of Pediatric Surgery-Department of Surgery, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-7098, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Enterocolitis, Necrotizing / mortality*,  surgery*
Female
Humans
Infant, Newborn
Infant, Newborn, Diseases / mortality*,  surgery*
Infant, Very Low Birth Weight
Logistic Models
Male
Patient Transfer / statistics & numerical data*
Retrospective Studies
Grant Support
ID/Acronym/Agency:
HD052885/HD/NICHD NIH HHS; K08 HD052885/HD/NICHD NIH HHS
Comments/Corrections

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


Previous Document:  Clinicopathologic characteristics of patients with resected multifocal intraductal papillary mucinou...
Next Document:  Resection after neoadjuvant therapy for locally advanced, "unresectable" pancreatic cancer.