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. 2024 Dec;44(12):1746-1754.
doi: 10.1038/s41372-024-02037-8. Epub 2024 Jul 12.

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

Amy B Hair  1 , Kevin M Sullivan  2   3 , Irfan Ahmad  4 , Isabella Zaniletti  5 , Shannon N Acker  6 , Muralidhar H Premkumar  7 , Kristina Reber  7 , Katie A Huff  8 , Sujir Pritha Nayak  9 , Robert DiGeronimo  10 , Jae Kim  11 , Jessica Roberts  12 , Troy A Markel  8 , Beverly Brozanski  13 , Jotishna Sharma  14 , Anthony J Piazza  12 , Toby D Yanowitz  15 ; Children’s Hospitals Neonatal Consortium Necrotizing Enterocolitis Focus Group
Affiliations

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

Amy B Hair et al. J Perinatol. 2024 Dec.

Abstract

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.

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Conflict of interest statement

Competing interests: The authors declare no competing interests. Ethics: IRB approval was obtained at each participating site prior to entering data into CHND. For analysis of de-identified data, the Stanley Manne Research Center (2011-14673) reviewed and approved this work. The study was performed in accordance with the Declaration of Helsinki.

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