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Updated: Feb 7, 2026

Orthotopic Kidney Auto-Transplantation in a Porcine Model Using 24 Hours Organ Preservation And Continuous Telemetry
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24-hour and 30-day perioperative mortality in pediatric surgery

Patrick C Bonasso1, M Sidney Dassinger1, Mark L Ryan1

  • 1Division of Pediatric Surgery, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

Journal of Pediatric Surgery
|July 19, 2018
PubMed

Insights

Necrotizing enterocolitis (NEC) is the leading cause of death in pediatric surgery, particularly within 24 hours of operation. Optimizing care for septic NEC patients is crucial to reduce mortality.

Area of Science:

  • Pediatric Surgery
  • Critical Care Medicine
  • Neonatalogy

Background:

  • Pediatric surgical mortality rates are low, making institutional analysis of deaths challenging.
  • Multi-institutional data analysis is essential for identifying perioperative death patterns in children.

Purpose of the Study:

  • To identify diagnoses associated with 24-hour and 30-day perioperative mortality in pediatric surgical patients.
  • To analyze patterns of perioperative death in a large cohort of children undergoing surgery.

Main Methods:

  • Retrospective review of the 2012-2015 Pediatric Participant Use Data File (PUF).
  • Statistical comparisons using Fischer's exact tests between survivors and nonsurvivors.
  • Analysis of 24-hour and 30-day mortality outcomes.

Main Results:

  • 103,444 patients evaluated; 732 deaths (0.7% 30-day mortality).
  • Necrotizing enterocolitis (NEC) linked to the highest 30-day mortality (19%).
  • NEC deaths predominantly occurred within 24 hours (67%); septic NEC patients required more inotropic support, had higher sepsis rates, and more transfusions.

Conclusions:

  • Necrotizing enterocolitis (NEC) accounts for the largest proportion of pediatric surgical perioperative deaths.
  • High immediate mortality in NEC necessitates targeted optimization of operative care for septic NEC patients.
Abstract

Keywords:
Necrotizing EnterocolitisPerioperative mortality

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