Perioperative support, not volume, is necessary to optimize outcomes in surgical management of necrotizing enterocolitis. Am J Surg 2017 Mar;213(3):502-506
Date
11/23/2016Pubmed ID
27871683Pubmed Central ID
PMC5346049DOI
10.1016/j.amjsurg.2016.11.014Scopus ID
2-s2.0-85006934232 (requires institutional sign-in at Scopus site) 2 CitationsAbstract
BACKGROUND: This study examines the relationship between hospital volume of surgical cases for necrotizing enterocolitis (NEC) and patient outcomes.
METHODS: A retrospective cross-sectional review was performed using the HCUP SID for California from 2007 to 2011. Patients with NEC who underwent surgery were identified using ICD-9CM codes. Risk-adjusted models were constructed with mixed-effects logistic regression using patient and demographic covariates.
RESULTS: 23 hospitals with 618 patients undergoing NEC-related surgical intervention were included. Overall mortality rate was 22.5%. There were no significant differences in the number of NICU beds (p = 0.135) or NICU intensivists (p = 0.469) between high and low volume hospitals. Following risk adjustment, no difference in mortality rate was observed between high and low volume hospitals respectively (24.0% vs. 20.3%, p = 0.555).
CONCLUSIONS: Our observation that neonates with NEC treated at low-volume centers have no increased risk of mortality may be explained by similar availability of NICU and intensivists resources across hospitals.
Author List
Cobb AN, Wong YM, Brownlee SA, Blanco BA, Ezure Y, Paddock HN, Kuo PC, Kothari ANAuthors
Adrienne Cobb MD Assistant Professor in the Surgery department at Medical College of WisconsinAnai N. Kothari MD Assistant Professor in the Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Cross-Sectional StudiesEnterocolitis, Necrotizing
Female
Hospitals, High-Volume
Hospitals, Low-Volume
Humans
Infant
Infant, Newborn
Intensive Care Units, Neonatal
Male
Retrospective Studies
United States
