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Multicenter Study
. 2010 Aug;157(2):203-208.e1.
doi: 10.1016/j.jpeds.2010.02.023. Epub 2010 May 6.

Risk factors for intestinal failure in infants with necrotizing enterocolitis: a Glaser Pediatric Research Network study

Debora Duro  1 , 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
Affiliations
Multicenter Study

Risk factors for intestinal failure in infants with necrotizing enterocolitis: a Glaser Pediatric Research Network study

Debora Duro et al. J Pediatr. 2010 Aug.

Abstract

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.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure
Figure
Study cohort enrolled from February 2004 through February 2007.
See this image and copyright information in PMC

References

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