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Eur J Pediatr Surg 2014; 24(05): 394-397
DOI: 10.1055/s-0033-1351665
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Mortality of Necrotizing Enterocolitis and Isolated Ileal Perforation at a Single Institution over the Past 40 Years

E. Marty Knott
1   Department of Surgery, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States
,
Alessandra Gasior
1   Department of Surgery, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States
,
Shawn St Peter
1   Department of Surgery, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States
,
Charles Snyder
1   Department of Surgery, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States
› Author Affiliations
Further Information

Publication History

25 May 2013

26 June 2013

Publication Date:
29 July 2013 (online)

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Abstract

Purpose 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.

Keywords

necrotizing enterocolitis - isolated intestinal perforation - mortality - risk factors
 

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