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Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Am+J+Surg 2017 ; 213 (3): 502-6 Nephropedia Template TP
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Perioperative Support, Not Volume, is Necessary to Optimize Outcomes in Surgical Management of Necrotizing Enterocolitis #MMPMID27871683
Cobb AN; Wong YM; Brownlee SA; Blanco BA; Ezure Y; Paddock HN; Kuo PC; Kothari AN
Am J Surg 2017[Mar]; 213 (3): 502-6 PMID27871683show ga
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 2007-2011. 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.