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Outcome in neonates with necrotizing enterocolitis and patent ductus arteriosus

World Journal of Pediatrics 2016年第1期12卷 55-59页

作者： Ulf Kessler Franzisca Schulte Dietmar Cholewa mathias nelle Stephan C.Schaefer Peter M.Klimek Steffen Berger Department of Pediatric Surgery InselspitalBern University Hospital and University of BernSwitzerland Division of Neonatology Department of PediatricsInselspitalBern University Hospital and University of BernSwitzerland Institute of Pathology InselspitalUniversity of BernBernSwitzerland Department of Surgery HFR Fribourg-Cantonal HospitalSwitzerland

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 infl uence of PDA on NEC ***:A retrospective study of 131 infants with established NEC was ***(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 ***: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 nonsurvival 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 ***,when important differences between the two study groups are controlled,only birth weight and disease severity may independently predict mortality.

关键词： congenital heart disease necrotizing enterocolitis neonatal mortality patent ductus arteriosus

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