Necrotizing enterocolitis vs bowel ischemia of congenital heart disease: Apples and oranges

IF 2.7 3区医学 Q1 SURGERY American journal of surgery Pub Date : 2025-01-15 DOI:10.1016/j.amjsurg.2025.116201

Catherine G. Williamson , Jordan M. Rook , Joanna Curry , Gerald Gollin , Peyman Benharash , Justin P. Wagner

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Abstract

Necrotizing enterocolitis (NEC) is a devastating illness with mortality rates approaching 26 %, with 4 % of patients with congenital heart disease (CHD) receiving this diagnosis. In this retrospective cohort study, the Pediatric Health Information System database was used to compare outcomes among patients with NEC diagnoses between 2019 and 2021 by CHD. The association of clinical factors with the outcomes of interest were compared using multivariable logistic regression. Of 2415 pediatric patients diagnosed with NEC, 955 (39.5 %) had a diagnosis of CHD. Those with CHD were more frequently White and born at a later gestational age. Antibiotic courses were similar; however, CHD patients had lower rates of post-antibiotic operations (18.0 % vs 32.1 %, p < 0.001) and in-hospital mortality (11.1 % vs 15.5 %, p = 0.001). On adjusted analysis, patients without CHD were twice as likely to undergo an abdominal operation. Compared with patients without CHD, those with CHD had decreased rates of antibiotic failure for NEC diagnosis despite similar treatment courses. Distinct outcomes of bowel ischemia among infants with CHD warrant further study of treatment strategies that may differ from those of classical NEC.

Type of study

Retrospective Cohort Study.

Level of evidence

III.

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坏死性小肠结肠炎与先天性心脏病肠缺血：苹果和橘子

坏死性小肠结肠炎（NEC）是一种毁灭性的疾病，死亡率接近26%，4%的先天性心脏病（CHD）患者接受这种诊断。在这项回顾性队列研究中，使用儿科健康信息系统数据库来比较2019年至2021年因冠心病诊断为NEC的患者的结局。使用多变量logistic回归比较临床因素与研究结果的关系。在诊断为NEC的2415例儿童患者中，955例（39.5%）诊断为冠心病。那些患有冠心病的人更经常是白种人，而且出生在较晚的胎龄。抗生素疗程相似；然而，冠心病患者的抗生素术后手术率较低(18.0% vs 32.1%, p

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.

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