Surgical Necrotizing Enterocolitis and Spontaneous Intestinal Perforation Lead to Severe Growth Failure in Infants.
Journal
Annals of surgery
ISSN: 1528-1140
Titre abrégé: Ann Surg
Pays: United States
ID NLM: 0372354
Informations de publication
Date de publication:
01 Sep 2024
01 Sep 2024
Historique:
medline:
12
9
2024
pubmed:
12
9
2024
entrez:
12
9
2024
Statut:
ppublish
Résumé
We aimed to determine the incidence of growth failure in infants with necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP) and whether initial laparotomy versus peritoneal drainage (PD) impacted the likelihood of growth failure. Infants with surgical NEC and SIP have high mortality, and most have neurodevelopmental impairment and poor growth. Existing literature on growth outcomes for these infants is limited. This is a preplanned secondary study of the Necrotizing Enterocolitis Surgery Trial dataset. The primary outcome was growth failure (Z-score for weight <-2.0) at 18 to 22 months. We used logistic regression, including diagnosis and treatment, as covariates. Secondary outcomes were analyzed using the Fisher exact or Pearson χ2 test for categorical variables and the Wilcoxon rank sum test or one-way ANOVA for continuous variables. Among 217 survivors, 207 infants (95%) had primary outcome data. Growth failure at 18 to 22 months occurred in 24/50 (48%) of NEC infants versus 65/157 (42%) SIP (P=0.4). The mean weight-for-age Z-score at 18 to 22 months in NEC infants was -2.05±0.99 versus -1.84±1.09 SIP (P=0.2), and the predicted mean weight-for-age Z-score SIP (Beta -0.27; 95% CI: -0.53, -0.01; P=0.041). Median declines in weight-for-age Z-score between birth and 18 to 22 months were significant in all infants but most severe (>2) in NEC infants (P=0.2). This first ever prospective study of growth outcomes in infants with surgical NEC or SIP demonstrates that growth failure is very common, especially in infants with NEC, and persists at 18-22 months.
Sections du résumé
OBJECTIVE
OBJECTIVE
We aimed to determine the incidence of growth failure in infants with necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP) and whether initial laparotomy versus peritoneal drainage (PD) impacted the likelihood of growth failure.
SUMMARY BACKGROUND DATA
BACKGROUND
Infants with surgical NEC and SIP have high mortality, and most have neurodevelopmental impairment and poor growth. Existing literature on growth outcomes for these infants is limited.
METHODS
METHODS
This is a preplanned secondary study of the Necrotizing Enterocolitis Surgery Trial dataset. The primary outcome was growth failure (Z-score for weight <-2.0) at 18 to 22 months. We used logistic regression, including diagnosis and treatment, as covariates. Secondary outcomes were analyzed using the Fisher exact or Pearson χ2 test for categorical variables and the Wilcoxon rank sum test or one-way ANOVA for continuous variables.
RESULTS
RESULTS
Among 217 survivors, 207 infants (95%) had primary outcome data. Growth failure at 18 to 22 months occurred in 24/50 (48%) of NEC infants versus 65/157 (42%) SIP (P=0.4). The mean weight-for-age Z-score at 18 to 22 months in NEC infants was -2.05±0.99 versus -1.84±1.09 SIP (P=0.2), and the predicted mean weight-for-age Z-score SIP (Beta -0.27; 95% CI: -0.53, -0.01; P=0.041). Median declines in weight-for-age Z-score between birth and 18 to 22 months were significant in all infants but most severe (>2) in NEC infants (P=0.2).
CONCLUSIONS
CONCLUSIONS
This first ever prospective study of growth outcomes in infants with surgical NEC or SIP demonstrates that growth failure is very common, especially in infants with NEC, and persists at 18-22 months.
Identifiants
pubmed: 39264354
doi: 10.1097/SLA.0000000000006378
pii: 00000658-202409000-00009
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
432-443Investigateurs
Richard A Polin
(RA)
Michael S Caplan
(MS)
Pablo J Sánchez
(PJ)
Leif D Nelin
(LD)
R Lawrence Moss
(RL)
Nathalie L Maitre
(NL)
Sudarshan R Jadcherla
(SR)
Patricia Luzader
(P)
Christine A Fortney
(CA)
Julie Gutentag
(J)
Keith O Yeates
(KO)
Christopher J Timan
(CJ)
Kristi L Small
(KL)
Rox Ann Sullivan
(RA)
Jacqueline McCool
(J)
Melanie Stein
(M)
Erin Fearns
(E)
Lorraine Kelly Quan
(LK)
Rajan K Thakkar
(RK)
Cole D Hague
(CD)
Stephanie Burkhardt
(S)
Jessica Purnell
(J)
Mary Ann Nelin
(MA)
Helen Carey
(H)
Lindsay Pietruszewski
(L)
Abbot R Laptook
(AR)
Martin Keszler
(M)
Arlet G Kurkchubasche
(AG)
Betty R Vohr
(BR)
Elisabeth C McGowan
(EC)
Angelita M Hensman
(AM)
Barbara Alksninis
(B)
Kristin Basso
(K)
Carmena Bishop
(C)
Robert T Burke
(RT)
Melinda Caskey
(M)
Laurie Hoffman
(L)
Katharine Johnson
(K)
Mary Lenore Keszler
(ML)
Teresa M Leach
(TM)
Emily Little
(E)
Elisabeth C McGowan
(EC)
Bonnie E Stephens
(BE)
Lucille St Pierre
(LS)
Elisa Vieira
(E)
Victoria E Watson
(VE)
Anna Maria Hibbs
(AM)
Nancy S Newman
(NS)
Edward M Barksdale
(EM)
Allison H Payne
(AH)
Deanne E Wilson-Costello
(DE)
Bonnie S Siner
(BS)
Monika Bhola
(M)
Gulgun Yalcinkaya
(G)
Eugenia K Pallotto
(EK)
Cheri Gauldin
(C)
George M Holcomb
(GM)
Shawn D St Peter
(SD)
Howard W Kilbride
(HW)
Anne Holmes
(A)
Kathy Johnson
(K)
Allison Scott
(A)
Prabhu S Parimi
(PS)
Lisa Gaetano
(L)
Kurt Schibler
(K)
Michael A Helmrath
(MA)
Stephanie L Merhar
(SL)
Tanya E Cahill
(TE)
Kimberly Yolton
(K)
Rebeccah Brown
(R)
Teresa L Gratton
(TL)
Cathy Grisby
(C)
Kristin Kirker
(K)
Sandra Wuertz
(S)
C Michael Cotten
(CM)
Ronald N Goldberg
(RN)
Matthew M Laughon
(MM)
Henry E Rice
(HE)
Obinna O Adibe
(OO)
Joanne Finkle
(J)
William F Malcolm
(WF)
Ricki F Goldstein
(RF)
William T Adamson
(WT)
Patricia L Ashley
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Kimberley A Fisher
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Sandra Grimes
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Kathryn E Gustafson
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Melody B Lohmeyer
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Carl L Bose
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Janice Bernhardt
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Gennie Bose
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Janice Wereszczak
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Stephen D Kicklighter
(SD)
Ginger Rhodes-Ryan
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Ravi M Patel
(RM)
David P Carlton
(DP)
Ira Adams-Chapman
(I)
Amina M Bhatia
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Ellen C Hale
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Yvonne Loggins
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Richard Ricketts
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Diane I Bottcher
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Salathiel Kendrick-Allwood
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Scott A Engum
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Lu-Ann Papile
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Heidi Harmon
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Patti L Pierce Tate
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Jenna Gabrio
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Jamie E Newman
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Carolyn M Petrie Huitema
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Kristin M Zaterka-Baxter
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Krisa P Van Meurs
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M Bethany Ball
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Gary E Hartman
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Karl Sylvester
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Barbara Bentley
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Elizabeth Bruno
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Maria Elena DeAnda
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Anne M DeBattista
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Lynne C Huffman
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Jean G Kohn
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Casey Krueger
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Nicholas H St John
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Hali Weiss
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John M Fiascone
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Brenda L MacKinnon
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Anne Kurfiss
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Ellen Nylen
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Paige T Church
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Waldemar A Carlo
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Namasivayam Ambalavanan
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Colin A Martin
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Reed A Dimmitt
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Myriam Peralta-Carcelen
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Carroll M Harmon
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Monica V Collins
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Kirstin J Bailey
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Uday Devaskar
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Meena Garg
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Stephen B Shew
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Teresa Chanlaw
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Tarah T Colaizy
(TT)
Edward F Bell
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John A Widness
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Jane E Brumbaugh
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Heidi M Harmon
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Dan L Ellsbury
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Joel Shilyansky
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Abbey C Hines
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Karen J Johnson
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Jacky R Walker
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Claire A Goeke
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Mendi L Schmelzel
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Tracy L Tud
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Conra Backstrom Lacy
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Sandra Brown
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Eric C Eichenwald
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Barbara Schmidt
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Haresh Kirpalani
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Alan Flake
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Aasma S Chaudhary
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Soraya Abbasi
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Toni Mancini
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Dara M Cucinotta
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Judy C Bernbaum
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Marsha Gerdes
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Hallam Hurt
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Jonathan Snyder
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Dale L Phelps
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Mary Rowan
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Jill Burnett
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Earl Maxson
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Richard A Ehrenkranz
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Harris Jacobs
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Patricia Cervone
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Monica Konstantino
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JoAnn Poulsen
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Janet Taft
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Christine A Gleason
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Marilee C Allen
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Robert J Boyle
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Traci Clemons
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(SJ)
Marian Willinger
(M)
Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
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