title: Risk factors for intestinal failure in infants with necrotizing enterocolitis: a Glaser Pediatric Research Network study.
abstract: OBJECTIVE
  To determine risk factors for intestinal failure (IF) in infants undergoing surgery for necrotizing enterocolitis (NEC).
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Gastroenterology and Nutrition, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA. dduro@med.miami.edu
authors.forename: Debora
authors.initials: D
authors.lastname: Duro
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Kalish
authors.forename: Patrick
authors.initials: P
authors.lastname: Johnston
authors.forename: Tom
authors.initials: T
authors.lastname: Jaksic
authors.forename: Maggie
authors.initials: M
authors.lastname: McCarthy
authors.forename: Cami
authors.initials: C
authors.lastname: Martin
authors.forename: James C Y
authors.initials: JC
authors.lastname: Dunn
authors.forename: Mary
authors.initials: M
authors.lastname: Brandt
authors.forename: Kerilyn K
authors.initials: KK
authors.lastname: Nobuhara
authors.forename: Karl G
authors.initials: KG
authors.lastname: Sylvester
authors.forename: R Lawrence
authors.initials: RL
authors.lastname: Moss
authors.forename: Christopher
authors.initials: C
authors.lastname: Duggan
mesh_terms: D001724:Birth Weight; D015331:Cohort Studies; D020345:Enterocolitis, Necrotizing / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D010372:Pediatrics / Q000379:methods; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D012778:Short Bowel Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery
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