Mortality of necrotizing enterocolitis expressed by birth weight categories
Mortality of necrotizing enterocolitis expressed by birth weight categories
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DOI：
10.1016/j.jpedsurg.2009.02.013
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发表时间：
2009-06-01
影响因子：
2.4
通讯作者：
Jaksic, Tom
中科院分区：
文献类型：
--
作者：
Fitzgibbons, Shimae Cross;Ching, Yiming;Jaksic, Tom
目的：低出生体重是发生坏死性小肠结肠炎（NEC）的最重要危险因素。我们的目的是建立以出生体重为基础的基准，在医院的新生儿死亡率与NEC.Methods：五百十一属于佛蒙特州牛津网络中心前瞻性评估71,808新生儿出生体重为501至1500克之间的2005年1月至2006年12月。主要结果变量为住院死亡率。结果：出生体重分为4类，250克的增量。随着出生体重的增加，NEC的危险性（P <0.001）和死亡率（P <0.001）降低。坏死性小肠结肠炎与每种类型的死亡显著相关（P <0.001）。各组间，NEC死亡率的比值比随着出生体重类别的增加而增加（1类= 1.6 vs 4类= 9.9; P <0.001）。结论：NEC新生儿的住院死亡率仍然很高，与出生体重类别显著相关。虽然NEC的风险和绝对死亡率随出生体重增加而降低，但比值比表明NEC对出生体重增加的死亡率有相对较大的影响。这些数据提供了基于出生体重的死亡率基准，可能有助于评估单中心NEC结局并促进中心之间的比较。(C)2009 Elsevier Inc. All rights reserved.
Purpose: Low birth weight is the most important risk factor for developing necrotizing enterocolitis (NEC). We aimed to establish birth weight-based benchmarks for in-hospital mortality in neonates with NEC.Methods: Five hundred eleven centers belonging to the Vermont Oxford Network prospectively evaluated 71,808 neonates with birth weight of 501 to 1500 g between January 2005 and December 2006. The primary outcome variable was in-hospital mortality.Results: Birth weight was divided into 4 categories by 250-g increments. The NEC risk (P < .001) and mortality (P < .001) decreased with higher birth weight category. Necrotizing enterocolitis was associated with a significant odds ratio for death for each category (P < .001). Across groups, the odds ratio for NEC mortality increased with higher birth weight category (category 1 = 1.6 vs category 4 = 9.9; P < .001).Conclusion: The in-hospital mortality rate of neonates with NEC remains high and is significantly related to birth weight category. Although the risk and absolute mortality of NEC decrease with higher birth weight, the odds ratios indicate that NEC has a relatively greater impact upon mortality at higher birth weight. These data afford birth weight-based mortality benchmarks that may be useful in assessing single center NEC outcomes and facilitating comparisons between centers. (C) 2009 Elsevier Inc. All rights reserved.