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Predictors of Mortality Among Very Low Birth Weight Infants With Gastrointestinal Perforation
Marina L Reppucci1, Eliza H Hersh1, Prerna Khetan1
1Division of General Surgery, Department of Surgery, Icahn School of Medicine Mount Sinai, USA.
Insights
Gastrointestinal perforation in very low birth weight infants is deadly. Key indicators of mortality include portal venous gas, severe metabolic acidosis, and elevated lactate levels at diagnosis.
Area of Science:
- Neonatalogy
- Pediatric Surgery
- Gastroenterology
Background:
- Gastrointestinal perforation is a significant cause of mortality in very low birth weight (VLBW) infants.
- Limited data exists on factors predicting mortality in these vulnerable infants.
Purpose of the Study:
- To identify pretreatment factors and patient characteristics independently associated with mortality in VLBW infants with GI perforation.
Main Methods:
- Retrospective review of VLBW infants with GI perforation from 2011-2018.
- Comparison of birth, laboratory, and disease-related factors between infants who survived and those who died.
Main Results:
- Eleven of 42 (26.19%) VLBW infants with GI perforation died.
- No significant differences were found in birth factors, hematology, pneumatosis, or bacteremia.
- Portal venous gas, severe metabolic acidosis, and elevated lactate at diagnosis were significantly more common in infants who died.
Conclusions:
- Portal venous gas, severe metabolic acidosis, and elevated lactate are associated with increased mortality risk in VLBW infants with GI perforation.
- Further research is needed to identify additional risk factors for mortality.
Background:
Gastrointestinal (GI) perforation is a risk factor for mortality in very low birth weight (VLBW) infants. Little data exist regarding pretreatment factors and patient characteristics known to independently correlate with risk of death.
Materials And Methods:
A retrospective review of all VLBW infants who sustained GI perforation between 2011 and 2018 was conducted. Birth, laboratory, and disease-related factors of infants who died were compared to those who survived.
Results:
42 VLBW infants who sustained GI perforations were identified. Eleven (26.19%) died. There were no significant differences in birth-related factors, hematological lab levels at diagnosis, presence of pneumatosis, or bacteremia. Portal venous gas (P = .03), severe metabolic acidosis (P < .01), and elevated lactate at diagnosis (P < .01) were statistically more likely to occur among infants who died.
Discussion:
Portal venous gas, severe metabolic acidosis, and elevated lactate were associated with an increased risk of mortality among VLBW infants who develop a GI perforation. Further research is required to better identify risk factors.
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