Postoperative characteristics of infants who developed necrotizing enterocolitis with different postnatal ages

Abstract

Our goal was to investigate the surgical procedures, postoperative complications, and survival with regard to different onset timing of necrotizing enterocolitis (NEC).We performed a retrospective review of medical records with a diagnosis of NEC between 2005 and 2016. The cutoff was set at 10 days for early onset ≤10 days and late onset over 10 days. Propensity score matching was performed to adjust for any baseline differences. In 53 paired patients, clinical outcomes, including, mortality, postoperative complications, and length of neonatal intensive care unit (NICU) stay, were evaluated on the basis of early or late-onset NEC.Successful 1:1 matching propensity score matching was performed with 208 infants. Mortality for early-onset NEC infants was lower than that of early late NEC infants (P = .026). A lower overall postoperative complication rate, including infectious complications [19 (35.8) vs 29 (54.7); odds ratio, 0.462, confidence interval (CI) 0.212–1.008, P = .039], was noted in patients with early-onset NEC compared with infants with late-onset NEC. NICU stay and major complication were marginal different between the 2 groups. Comparison of feeding outcomes revealed that the time to achieve full enteral feeds was significantly longer for those with late-onset NEC (18.1 ± 11.5 vs 26.3 ± 15.6, P = .008).The infants who develop NEC after 10 days of life do influence postoperative outcome survival or other clinically important outcomes after laparotomy.

Short-term feeding outcomes in preterm twins with birthweight difference: a comparison between the larger and smaller infants

“…Lower birth weight and SGA/IUGR has been proved to be associated with delayed total enteral feeding in many studies [9,20,23].The inferior feeding tolerance and outcomes in them were probably due to the redistribution of blood ow in fetal and the persist abnormalities of gastrointestinal blood ow postnatal [28,29].Those smaller infants with a higher proportion of SGA,was supposed to have a longer duration of time to achieving total enteral feeding.However,in our study, no statistical difference was found between groups at the time of achieving total enteral feeding or FI.That is inconsistent with the studies of Xiang Y, et al [30]. and Hu F, et al [31].We speculated the reason is probably the subject of our study were mainly late preterm infants,who has a relatively better tolerance of enteral feeding, diminishing the effect of lower birth weight on enteral feeding,in addition, those factors that might affect enteral feeding were not signi cantly different between groups [32][33][34][35][36][37].…”

Incomplete resection of necrotic bowel may increase mortality in infants with necrotizing enterocolitis

“…Our findings are similar to several past studies ( 19 – 25 ). Li et al ( 21 ) noted that infants with earlier onset of NEC had achieved full feedings earlier (means ± standard deviation 18.1±11.5 vs . 26.3±15.6 days, p =0.008), had less mortality ( p =0.026), and showed a trend for fewer infections [19/53 (35.8%) vs .…”

Early postoperative outcomes of surgery for intestinal perforation in NEC based on intestinal location of disease

“…When the disease was limited, the outcome seemed more favorable. [ 20 , 21 ] The lower survival was observed for infants with pan-intestinal involvement compared with limited disease of NEC. [ 22 , 23 ] In the present study, when the rectum, jejunum, and ileum were involved for the disease, which means greater extent, there were more patients who died.…”