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Outcome in neonates with necrotizing enterocolitis and patent ductus arteriosus.
Kessler, Ulf; Schulte, Franzisca; Cholewa, Dietmar; Nelle, Mathias; Schaefer, Stephan C; Klimek, Peter M; Berger, Steffen.
Afiliación
  • Kessler U; Department of Pediatric Surgery, Inselspital, University Hospital and University of Bern, Bern, Switzerland.
  • Schulte F; Department of Surgery, HFR Fribourg-Cantonal Hospital, Bern, Switzerland.
  • Cholewa D; Department of Pediatric Surgery, Inselspital, University Hospital and University of Bern, Bern, Switzerland.
  • Nelle M; Department of Pediatric Surgery, Inselspital, University Hospital and University of Bern, Bern, Switzerland.
  • Schaefer SC; Division of Neonatology, Department of Pediatrics, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
  • Klimek PM; Institute of Pathology, Inselspital, University of Bern, Bern, Switzerland.
  • Berger S; Department of Pediatric Surgery, Inselspital, University Hospital and University of Bern, Bern, Switzerland.
World J Pediatr ; 12(1): 55-9, 2016 Feb.
Article en En | MEDLINE | ID: mdl-26684305
BACKGROUND: There is no agreement of the influence of patent ductus arteriosus (PDA) on outcomes in patients with necrotizing enterocolitis (NEC). In this study, we assessed the influence of PDA on NEC outcomes. METHODS: A retrospective study of 131 infants with established NEC was performed. Outcomes (death, disease severity, need for surgery, hospitalization duration), as well as multiple clinical parameters were compared between NEC patients with no congenital heart disease (n=102) and those with isolated PDA (n=29). Univariate, multivariate and stepwise logistic regression analyses were performed. RESULTS: Birth weight and gestational age were significantly lower in patients with PDA [median (95% CI): 1120 g (1009-1562 g), 28.4 wk (27.8-30.5 wk)] than in those without PDA [median (95% CI): 1580 g (1593-1905 g), 32.4 wk (31.8-33.5 wk); P<0.05]. The risk of NEC-attributable fatality was higher in NEC patients with PDA (35%) than in NEC patients without PDA (14%)[univariate odds ratio (OR)=3.3, 95% CI: 1.8-8.6, P<0.05; multivariate OR=2.4, 95% CI: 0.82-2.39, P=0.111]. Significant independent predictors for non-survival within the entire cohort were advanced disease severity stage III (OR=27.9, 95% CI: 7.4-105, P<0.001) and birth weight below 1100 g (OR=5.7, 95% CI: 1.7-19.4, P<0.01). CONCLUSIONS: In patients with NEC, the presence of PDA is associated with an increased risk of death. However, when important differences between the two study groups are controlled, only birth weight and disease severity may independently predict mortality.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enterocolitis Necrotizante / Conducto Arterioso Permeable Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Newborn Idioma: En Revista: World J Pediatr Asunto de la revista: PEDIATRIA Año: 2016 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Suiza
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enterocolitis Necrotizante / Conducto Arterioso Permeable Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Newborn Idioma: En Revista: World J Pediatr Asunto de la revista: PEDIATRIA Año: 2016 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Suiza