Factores pronóstico para mortalidad en neonatos con enterocolitis necrosante

Bracho-Blanchet, Eduardo; Torrecilla-Navarrete, María Esther; Zalles-Vidal, Cristian; Ibarra-Ríos, Daniel; Fernandez-Portilla, Emilio; Dávila-Pérez, Roberto

doi:10.1016/j.circir.2015.02.002

Cited by 8 publications

(7 citation statements)

References 15 publications

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“…Many risk factors, including sepsis, respiratory failure, stage III NEC, intestinal perforation and peritonitis, have previously been reported to be associated with poor outcomes in infants with NEC 10 26 27 28 29 , most of which were also associated with poor prognosis in full-term infants with NEC in the present study. Additionally, patients in the nonsurvivor group more frequently required dopamine support and plasma transfusion relative to survivor group patients.…”

Section: Discussionsupporting

confidence: 58%

Differences in the Clinical Characteristics of Early- and Late-Onset Necrotizing Enterocolitis in Full-Term Infants: A Retrospective Case-Control Study

Liu

et al. 2017

Sci Rep

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Information regarding the influence of age at onset on prognosis in full-term infants with necrotizing enterocolitis (NEC) is limited, and identifying differences between the clinical characteristics of early-onset NEC (EO-NEC) and late-onset NEC (LO-NEC) may be helpful in the determination of effective management strategies. In the present study, the medical records of 253 full-term infants with NEC were reviewed, and the clinical characteristics of the EO-NEC group (n = 150) and the LO-NEC group (n = 103) were compared. Infants in the EO-NEC group were characterized by increased gestational age and higher rates of stage III NEC and peritonitis when compared with LO-NEC infants (P < 0.05). Mortality was significantly associated with stage III NEC, peritonitis, sepsis, respiratory failure and shock in univariate analysis (P < 0.05). In logistic regression analysis, peritonitis and renal failure were identified as independent risk factors for mortality in infants with EO-NEC, and peritonitis and respiratory failure were significant predictors of mortality in neonates with LO-NEC. Our finding indicated that the characteristics of the severe medical conditions identified in infants with EO-NEC were distinct from those observed in infants with LO-NEC. Peritonitis and kidney failure and peritonitis and respiratory failure were identified as risk factors for mortality in EO-NEC and LO-NEC infants, respectively.

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Section: Discussionsupporting

confidence: 58%

Differences in the Clinical Characteristics of Early- and Late-Onset Necrotizing Enterocolitis in Full-Term Infants: A Retrospective Case-Control Study

Liu

et al. 2017

Sci Rep

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“…Recent studies confirm the association of deplasmatized red blood cell transfusion for anemia and necrotizing enterocolitis[ 33 - 35 ]. Other studies assessing the effect of administering erythropoietin and iron agents for anemia found a lower incidence of necrotizing enterocolitis[ 33 ].…”

Section: Discussionmentioning

confidence: 87%

“…In more than half of the study subjects (54.5%) that died from GIP, anemia had been diagnosed even before the clinical signs of the diseases that caused GIP. In their recent study, Bracho-Blanchet et al[ 35 ] also identified anemia as a prognostic factor associated with mortality in newborns with necrotizing enterocolitis.…”

Section: Discussionmentioning

confidence: 99%

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Perinatal risk factors in newborns with gastrointestinal perforation

Prgomet

Lukšić

Pogorelić

et al. 2017

WJGS

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AIMTo investigate correlation of perinatal risk factors in newborns with gastrointestinal perforation (GIP).METHODSSingle-center retrospective cohort study was conducted between January 1990 and December 2012. Medical records on all newborns with GIP were reviewed (n = 35). Surgical records and histopathologic examination of all perforated intestine samples were also reviewed.RESULTSThe most common cause of GIP was necrotizing enterocolitis (51.4%). The most common site of perforation was large intestine. Mortality rate was 31%. Infants with GIP more frequently had very low birth weight (< 1500 g), especially birth weight below 10th percentile according to gestational age. Ponderal index was not differing between infants with GIP and control subjects. In infants with GIP anemia was more frequently found than in control group.CONCLUSIONGIP in newborns is mostly disease of infants with birth weight below 10th percentile according to gestational age. GIP occurs more often in infants with anemia.

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“…[47,48] Infection at the surgical site constitutes the primary cause of infection associated with surgical care (40% of postsurgical infections), [19] and is the third leading cause of infection associated with medical treatment in children (14%-16%). [47][48][49][50][51][52] Wound sepsis is preventable but, despite advances in surgical technique, continues to be one of the main challenges in treatment of congenital intestinal malformations. In our study, infectious complications were uncommon, even among patients who did not survive.…”

Section: Original Researchmentioning

confidence: 99%

Neonatal Surgery Case Fatality and Associated Factors in a Cuban Pediatric Hospital, 2005–2015

2017

MEDICC Review

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INTRODUCTION Newborns in need of surgery are a challenge to manage and require highly specialized centers with multidisciplinary surgical teams. Since the 1980s, neonatal surgical survival has increased by up to 70% in some countries, mainly due to advances in neonatal intensive care, anesthesia and surgical technique. OBJECTIVE Describe surgical case fatality and survival in a neonatal reference hospital in Cuba, estimate risk of death, and identify potential risk predictors among neonatal characteristics.METHODS A retrospective cohort study was conducted based on hospital administrative data and clinical records for a series of surgical cases in the neonatal intensive care unit of Havana's William Soler University Children's Hospital from January 2005 to December 2015. All neonates who underwent surgery during the study period were included. The dependent variable was discharge status (alive, deceased); independent variables were: sex, age (in days) at time of surgery, gestational age, birth weight, indication for surgery, surgical order (fi rst, repeat), and presence of sepsis or other postoperative complications. The study used contingency tables to analyze associations between neonatal characteristics and discharge status. A classifi cation tree was used to obtain simple estimates of surgical risk.RESULTS Survival was 91.3% (675/739) among 739 neonates who underwent surgery. The majority were male (58.7%, 434/739), full term (84.2%, 622/739), and of normal birth weight (80.6%, 596/739). Most surgeries were performed in the fi rst 10 days of life. Digestive system anomalies constituted the most common surgical indication (57.6%, 426/739); among these anorectal malformations (26.8%, 114/426) and esophageal atresia (17.4%, 74/426) predominated. Survival rates were lower for digestive perforation (57.7%, 15/26), gastroschisis (57.1%, 4/7) and intestinal atresia (73%, 27/37). Neonates in the youngest and oldest age groups at time of surgery faced highest risk of death, especially those in the older group. Term infants with normal birth weight operated on for the fi rst time had survival rates >95%.CONCLUSIONS Survival was high and low birth weight conferred the worst prognosis. Infants with normal birth weight operated on for the fi rst time had the greatest probability of survival.

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Factores pronóstico para mortalidad en neonatos con enterocolitis necrosante

Abstract: We must be aware of the factors associated with mortality, as well as those associated with surgical treatment to reduce overall mortality for this condition.

Cited by 8 publications

References 15 publications

Differences in the Clinical Characteristics of Early- and Late-Onset Necrotizing Enterocolitis in Full-Term Infants: A Retrospective Case-Control Study

Differences in the Clinical Characteristics of Early- and Late-Onset Necrotizing Enterocolitis in Full-Term Infants: A Retrospective Case-Control Study

Perinatal risk factors in newborns with gastrointestinal perforation

Neonatal Surgery Case Fatality and Associated Factors in a Cuban Pediatric Hospital, 2005–2015

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