title: Outcome in VLBW infants with surgical intestinal disorder at 18 months of corrected age.
abstract: BACKGROUND
  Surgical intestinal disorders, such as necrotizing enterocolitis (NEC), focal intestinal perforation (FIP), and meconium-related ileus (MRI), are serious morbidities in very low-birthweight infants (VLBWI). The aim of this study was to compare the composite outcomes of death or neurodevelopmental impairment (NDI) in VLBWI with surgical intestinal disorders and assess independent risk factors for death and NDI at 18 months of corrected age.
  
  
  METHODS
  A retrospective matched-cohort study was conducted at 11 institutes. We included VLBWI who had undergone laparotomy for NEC, FIP, and MRI. Two control subjects were chosen for every surgical patient and matched for gestational age and birthweight to form the comparison group. Death and neurodevelopmental outcome at 18 months of corrected age were evaluated.
  
  
  RESULTS
  The number of infants in the NEC, FIP, MRI, and control groups was 44, 47, 42, and 261, respectively. In-hospital mortality was higher in infants with NEC and MRI relative to those in the control group (P < 0.001). The incidence rate for NDI at 18 months of corrected age was higher in infants with MRI relative to those in the control group (P = 0.021). On logistic regression analysis, low gestational age, male sex, small for gestational age, intraventricular hemorrhage, and MRI were associated with increased risk of death or NDI at 18 months of corrected age.
  
  
  CONCLUSIONS
  NEC and MRI were associated with in-hospital mortality, and MRI was associated with NDI or death at 18 months of corrected age.
authors: Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan.
authors: Masahiro
authors: M
authors: Hayakawa
authors: Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors: Tomoaki
authors: T
authors: Taguchi
authors: Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan.
authors: Naoto
authors: N
authors: Urushihara
authors: Department of Pediatric Surgery, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors: Akiko
authors: A
authors: Yokoi
authors: Department of Surgery, Kanagawa Children's Medical Center, Yokohama, Japan.
authors: Hiroshi
authors: H
authors: Take
authors: Department of Neonatology, Osaka Medical Center and Research Institute for Maternal and Child Health, Tokyo, Japan.
authors: Jun
authors: J
authors: Shiraishi
authors: Division of Neonatology, Center for Maternal-Fetal and Neonatal Medicine, National Center for Child Health and Development, Tokyo, Japan.
authors: Hideshi
authors: H
authors: Fujinaga
authors: Department of Pediatric Surgery, Nihon University School of Medicine, Tokyo, Japan.
authors: Kensuke
authors: K
authors: Ohashi
authors: Department of Neonatology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
authors: Makoto
authors: M
authors: Oshiro
authors: Department of Pediatrics, Anjo Kosei Hospital, Anjo, Japan.
authors: Yuichi
authors: Y
authors: Kato
authors: Department of Public Health, Osaka City University Faculty of Medicine, Osaka, Japan.
authors: Satoko
authors: S
authors: Ohfuji
authors: Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita, Japan.|Department of Pediatric Surgery, Hyogo College of Medicine, Nishinomiya, Japan.
authors: Hiroomi
authors: H
authors: Okuyama
mesh_terms: D000328:Adult; D013505:Digestive System Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000401:mortality / Q000601:surgery*; D007410:Intestinal Diseases / Q000401:mortality / Q000601:surgery*; D007564:Japan / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors
keywords: focal intestinal perforation; meconium-related ileus; necrotizing enterocolitis; outcome; very low birth weight infants