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Blood transfusions, increased rates of surgical NEC, and lower survival: a propensity score-matched analysis.

Abstract：

PURPOSE:We sought to investigate the association between blood transfusions (BT), rates of necrotizing enterocolitis requiring surgical intervention (SNEC), and survival. METHODS:Blood transfusions in premature infants were identified in the Kids' Inpatient Database (2003-2009). Propensity score-matched analysis compared SNEC outcomes in BT vs. non-BT groups. Multivariate analyses were performed to determine independent predictors of outcome. RESULTS:Overall, 663740 cases were identified and 4.9% received BT. Surgical necrotizing enterocolitis occurred in 493 cases in the BT group, while SNEC occurred in 1049 cases in the non-BT group. Propensity score analysis of 20991 BT and 20988 non-BT cases demonstrated higher SNEC rates with BT (odds ratio [OR], 1.21) vs non-BT. Surgical necrotizing enterocolitis with BT had lower survival rates (58%) vs non-BT (67%). Surgical necrotizing enterocolitis with BT had lower length of stay and total charges vs non-BT. On multivariate analyses, SNEC mortality with BT increased for lower gestational age, males (OR, 45.7), African Americans (OR, 64.4), and infants with cardiac anomalies (OR, 50.8) or bronchopulmonary dysplasia (OR, 177). Non-BT SNEC demonstrated higher mortality with lower gestational age and infants with bronchopulmonary dysplasia (OR, 6.56) or sepsis (OR, 3.66). CONCLUSION:On propensity score-matched analysis, SNEC occurs at higher rates after BT and is associated with lower survival and lower resource utilization vs SNEC without BT.

journal_name

J Pediatr Surg

journal_title

Journal of pediatric surgery

authors

Sayari AJ,Tashiro J,Sola JE,Perez EA

doi

10.1016/j.jpedsurg.2016.02.052

subject

Has Abstract

pub_date

2016-06-01 00:00:00

pages

927-31

issue

6

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(16)00140-8

journal_volume

51

pub_type

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