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Impact of Transfer for Surgical Management of Preterm Necrotising Enterocolitis or Focal Intestinal Perforation

Lookup NU author(s): Dr Claire Granger, Professor Nicholas EmbletonORCiD, Dr Robert Tinnion, Dr Janet Berrington


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© 2023 Elsevier Inc.Objective: To compare outcomes after surgically managed necrotising enterocolitis (NEC) and focal intestinal perforation (FIP) in infants <32 weeks requiring transfer to or presenting in a single surgical centre. Design: Retrospective review of transferred and inborn NEC or FIP, from January 2013 to December 2020. Patients: 107 transfers with possible NEC or FIP contributed 92 cases (final diagnoses NEC (75) and FIP (17)); 113 inborn cases: NEC (84) and FIP (29). Results: In infants with a final diagnosis of NEC, medical management after transfer was as common as when inborn (41% TC vs 54% p = 0.12). Unadjusted all-cause mortality was lower in inborn NEC (19% vs 27%) and FIP (10% vs 29%). In infants undergoing surgery unadjusted mortality attributable to NEC or FIP was lower if inborn (21% vs 41% NEC, 7% vs 24% FIP). In regression analysis of surgically treated infants, being transferred was associated with increased all-cause mortality (OR 2.55 (1.03–6.79)) and mortality attributable to NEC or FIP (OR 4.89 (1.80–14.97)). Conclusions: These data require replication, but if confirmed, suggest that focusing care for infants at highest risk of developing NEC or FIP in a NICU with on-site surgical expertise may improve outcomes.

Publication metadata

Author(s): Granger CL, Mukherjee K, Embleton ND, Tinnion RJ, Berrington JE

Publication type: Article

Publication status: Published

Journal: Journal of Pediatric Surgery

Year: 2023

Volume: 858

Issue: 10

Pages: 1971-1981

Print publication date: 01/10/2023

Online publication date: 29/03/2023

Acceptance date: 24/03/2023

ISSN (print): 0022-3468

ISSN (electronic): 1531-5037

Publisher: Elsevier


DOI: 10.1016/j.jpedsurg.2023.03.016


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