دورية أكاديمية
أعرض في EDS

Variation in Complications and Mortality According to Infant Diagnosis.

التفاصيل البيبلوغرافية
العنوان: Variation in Complications and Mortality According to Infant Diagnosis.
المؤلفون: Mehl SC; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.; Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX., Portuondo JI; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX., Fallon SC; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX., Shah SR; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.; Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX., Wesson DE; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.; Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX., Vogel AM; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.; Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX., King A; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.; Division of Pediatric Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX., Lopez ME; Department of Pediatric Surgery, Section of Surgical Sciences, Vanderbilt University, Nashville, TN., Massarweh NN; Surgical and Perioperative Care, Atlanta VA Health Care System, Decatur, GA.; Division of Surgical Oncology, Department of Surgery, Emory University School of Medicine, Atlanta, GA.; Department of Surgery, Morehouse School of Medicine, Atlanta, GA.
المصدر: Annals of surgery [Ann Surg] 2023 Jul 01; Vol. 278 (1), pp. e165-e172. Date of Electronic Publication: 2022 Aug 09.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0372354 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-1140 (Electronic) Linking ISSN: 00034932 NLM ISO Abbreviation: Ann Surg Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Philadelphia, PA : Lippincott Williams & Wilkins
مواضيع طبية MeSH: Hernias, Diaphragmatic, Congenital*/complications , Enterocolitis, Necrotizing*/surgery, Infant, Newborn ; Infant ; Humans ; Child ; Treatment Outcome ; Postoperative Complications/etiology ; Retrospective Studies
مستخلص: Objective: Investigate patterns of infant perioperative mortality, describe the infant diagnoses with the highest mortality burden, and evaluate the association between types of postoperative complications and mortality in infants.
Background: The majority of mortality events in pediatric surgery occur among infants (ie, children <1 y old). However, there is limited data characterizing patterns of infant perioperative mortality and diagnoses that account for the highest proportion of mortality.
Methods: Infants who received inpatient surgery were identified in the National Surgical Quality Improvement Program-Pediatric database (2012-2019). Perioperative mortality was stratified into mortality associated with a complication or mortality without a complication. Complications were categorized as wound infection, systemic infection, pulmonary, central nervous system, renal, or cardiovascular. Multivariable logistic regression was used to evaluate the association between different complications and complicated mortality.
Results: Among 111,946 infants, the rate of complications and perioperative mortality was 10.4% and 1.6%, respectively. Mortality associated with a complication accounted for 38.8% of all perioperative mortality. Seven diagnoses accounted for the highest proportion of mortality events (40.3%): necrotizing enterocolitis (22.3%); congenital diaphragmatic hernia (7.3%); meconium peritonitis (3.8%); premature intestinal perforation (2.5%); tracheoesophageal fistula (1.8%); gastroschisis (1.4%); and volvulus (1.1%). Relative to wound complications, cardiovascular [odds ratio (OR): 19.4, 95% confidence interval (95% CI): 13.9-27.0], renal (OR: 6.88; 4.65-10.2), and central nervous system complications (OR: 6.50; 4.50-9.40) had the highest odds of mortality for all infants.
Conclusions: A small subset of diagnoses account for 40% of all infant mortality and specific types of complications are associated with mortality. These data suggest targeted quality improvement initiatives could be implemented to reduce adverse surgical outcomes in infants.
Competing Interests: The authors report no conflicts of interest.
(Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
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تواريخ الأحداث: Date Created: 20220809 Date Completed: 20230612 Latest Revision: 20230923
رمز التحديث: 20231215
DOI: 10.1097/SLA.0000000000005658
PMID: 35943204
قاعدة البيانات: MEDLINE
الوصف
تدمد:1528-1140
DOI:10.1097/SLA.0000000000005658