Necrotizing enterocolitis in 20,822 infants: analysis of medical and surgical treatments.
Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency of the neonate. Previous information about this disease has largely been gathered from limited series. We analyzed 13 years of the National Inpatient Sample (NIS) and 3 years of the Kids' Inpatient Database (KID; 1997, 2000, 2003) to generate the most comprehensive profile of outcomes to date of medically versus surgically treated NEC. We identified 20 822 infants with NEC, of whom 15,419 (74.1%) and 5403 (25.9%) were undergoing medical and surgical management, respectively. Overall, surgical patients had greater length of stay, total hospital charges, and mortality. Among infants dying during admission, there was no significant difference in length of stay or charges between the medical and surgical groups. These findings highlight the need for developing a clinically relevant risk stratification tool to identify NEC patients at high risk for death.
Abdullah
Fizan
F
Center for Pediatric Surgical Clinical Trials & Outcomes Research, Division of Pediatric Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287-0005, USA. fa@jhmi.edu
Zhang
Yiyi
Y
Camp
Melissa
M
Mukherjee
Debraj
D
Gabre-Kidan
Alodia
A
Colombani
Paul M
PM
Chang
David C
DC
D015331:Cohort Studies; D003082:Colectomy; D004322:Drainage; D020345:Enterocolitis, Necrotizing / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D004766:Enterostomy; D005260:Female; D017722:Hospital Charges; D017052:Hospital Mortality; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome