Initial surgery for spontaneous intestinal perforation in extremely low birth weight infants is not associated with mortality or in-hospital morbidities

期刊论文
发表日期：

2024年7月12日

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Amy B. Hair,
Kevin M. Sullivan,
Irfan Ahmad,
Isabella Zaniletti,
Shannon N. Acker,
Muralidhar H. Premkumar,
Kristina Reber,
Katie A. Huff,
Sujir Pritha Nayak,
Robert DiGeronimo,
Jae Kim,
Jessica Roberts,
Troy A. Markel,
Beverly Brozanski,
Jotishna Sharma,
Anthony J. Piazza,
Toby D. Yanowitz

摘要

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.