Document Detail


Risk factors for intestinal failure in infants with necrotizing enterocolitis: a Glaser Pediatric Research Network study.
MedLine Citation:
PMID:  20447649     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine risk factors for intestinal failure (IF) in infants undergoing surgery for necrotizing enterocolitis (NEC).
STUDY DESIGN: Infants were enrolled in a multicenter prospective cohort study. IF was defined as the requirement for parenteral nutrition for >or= 90 days. Logistic regression was used to identify predictors of IF.
RESULTS: Among 473 patients enrolled, 129 had surgery and had adequate follow-up data, and of these patients, 54 (42%) developed IF. Of the 265 patients who did not require surgery, 6 (2%) developed IF (OR 31.1, 95% CI, 12.9 - 75.1, P < .001). Multivariate analysis identified the following risk factors for IF: use of parenteral antibiotics on the day of NEC diagnosis (OR = 16.61, P = .022); birth weight < 750 grams, (OR = 9.09, P < .001); requirement for mechanical ventilation on the day of NEC diagnosis (OR = 6.16, P = .009); exposure to enteral feeding before NEC diagnosis (OR=4.05, P = .048); and percentage of small bowel resected (OR = 1.85 per 10 percentage point greater resection, P = .031).
CONCLUSION: The incidence of IF among infants undergoing surgical treatment for NEC is high. Variables characteristic of severe NEC (low birth weight, antibiotic use, ventilator use, and greater extent of bowel resection) were associated with the development of IF.
Authors:
Debora Duro; Leslie A Kalish; Patrick Johnston; Tom Jaksic; Maggie McCarthy; Cami Martin; James C Y Dunn; Mary Brandt; Kerilyn K Nobuhara; Karl G Sylvester; R Lawrence Moss; Christopher Duggan
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-05-06
Journal Detail:
Title:  The Journal of pediatrics     Volume:  157     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-16     Completed Date:  2010-08-09     Revised Date:  2013-06-10    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  203-208.e1     Citation Subset:  AIM; IM    
Copyright Information:
Copyright (c) 2010 Mosby, Inc. All rights reserved.
Affiliation:
Division of Gastroenterology and Nutrition, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA. dduro@med.miami.edu
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MeSH Terms
Descriptor/Qualifier:
Birth Weight
Cohort Studies
Enterocolitis, Necrotizing / complications*,  diagnosis*,  surgery
Female
Gestational Age
Humans
Infant, Newborn
Male
Multivariate Analysis
Odds Ratio
Pediatrics / methods
Pregnancy
Prospective Studies
Risk Factors
Short Bowel Syndrome / complications*,  diagnosis*,  surgery
Grant Support
ID/Acronym/Agency:
K24 HD058795/HD/NICHD NIH HHS; P30 DK040561-15/DK/NIDDK NIH HHS; P30 DK40561-13/DK/NIDDK NIH HHS; T32-HD43034-05A1/HD/NICHD NIH HHS
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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