title: Mortality of necrotizing enterocolitis and isolated ileal perforation at a single institution over the past 40 years.
abstract: OBJECTIVE
  Controversy exists regarding differences in mortality between isolated ileal perforation (IIP) and necrotizing enterocolitis (NEC). We sought to identify risk factors and determine mortality rates for these two entities.
  
  
  METHODS
  A retrospective review was conducted on all patients with NEC or IIP undergoing surgical management at our institution from May 1971 to December 2011. Demographics, birth history, management strategies, and mortality were recorded. Chi-square and unpaired t-test were used where appropriate.
  
  
  RESULTS
  During the study period, 236 patients underwent operative management with 17.8% of those being for IIP. Patients with IIP had a lower estimated gestational age (27.8 ± 3.0 vs. 29.5 ± 4.2 weeks, p = 0.014), were more likely to be of multiple gestation (33.3 vs. 16.5%, p = 0.022), and were younger at diagnosis (8.7 ± 8.1 vs. 14.3 ± 11.1 days, p = 0.003) compared with those undergoing operation for NEC. Mortality was threefold lower with IIP (9.5 vs. 36.1%, p < 0.001).
  
  
  CONCLUSIONS
  IIP carries a unique set of risk factors and has a significantly lower mortality rate when compared with NEC.
authors.affiliation: Department of Surgery, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States.
authors.forename: E Marty
authors.initials: EM
authors.lastname: Knott
authors.affiliation: Department of Surgery, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Gasior
authors.affiliation: Department of Surgery, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States.
authors.forename: Shawn
authors.initials: S
authors.lastname: St Peter
authors.affiliation: Department of Surgery, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States.
authors.forename: Charles
authors.initials: C
authors.lastname: Snyder
mesh_terms: D017668:Age of Onset; D020345:Enterocolitis, Necrotizing / Q000150:complications / Q000401:mortality* / Q000601:surgery; D005260:Female; D005865:Gestational Age; D006801:Humans; D007077:Ileal Diseases / Q000209:etiology / Q000401:mortality*; D007231:Infant, Newborn; D007416:Intestinal Perforation / Q000209:etiology / Q000401:mortality*; D008297:Male; D009099:Multiple Birth Offspring; D012189:Retrospective Studies; D012307:Risk Factors