Division of Pediatric Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida.
Division of Pediatric Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida.
J Surg Res. 2014 Aug;190(2):613-22. doi: 10.1016/j.jss.2014.02.003. Epub 2014 Feb 12.
Patent ductus arteriosus (PDA) is a condition that commonly affects premature and low birth weight (BW) infants at times necessitating surgical intervention. We examined outcomes after surgical ligation (SL).
We analyzed the Kids' Inpatient Database for premature infants diagnosed with PDA, admitted at <8 d of age. Patient demographics, disposition, morbidity, and mortality were analyzed. All cases were weighted appropriately to project nationally representative estimates.
A total of 63,208 patients were identified with diagnosis of PDA. Of these, 6766 (10.7%) underwent SL. Lower gestational age (GA) and BW patients had higher incidence of PDA and rates of SL. Overall survival was 90.8% for the cohort. Survival for the SL group was 88.0% and 91.2% for the non-SL group; however, infants undergoing SL had higher survival rates up to 28 wk and 1250 g for GA and BW, respectively. GA did not affect post-SL survival adversely. Rather, lower BW was associated with extremely high mortality rates. Black infants and boys had lower survival compared with other races and girls, respectively. Larger hospitals had higher survival rates, but hospital location, teaching status, and type did not affect survival. Payer status and income quartile did not affect survival.
PDA and SL are more common in lower BW and GA groups. Higher survival rates are found for infants with SL versus non-SL in the lowest BW and GA groups. Morbidity and mortality are not affected by SL timing. BW, rather than GA, determines survival of infants undergoing SL.
动脉导管未闭（PDA）是一种常见于早产儿和低出生体重（BW）婴儿的疾病，有时需要手术干预。我们检查了手术后结扎（SL）的结果。
我们分析了 Kids' Inpatient Database 中诊断为 PDA 的早产儿病例，这些婴儿在 <8 天龄时入院。分析了患者的人口统计学、处置、发病率和死亡率。所有病例均经过适当加权，以预测全国代表性估计值。
共确定了 63208 例患有 PDA 的患者。其中，6766 例（10.7%）接受了 SL。较低的胎龄（GA）和 BW 患者 PDA 的发生率和 SL 率更高。总体生存率为 90.8%。SL 组的生存率为 88.0%，非 SL 组为 91.2%；然而，接受 SL 的婴儿在 GA 和 BW 分别达到 28 周和 1250 克时的生存率更高。GA 并没有对 SL 后的生存率产生不利影响。相反，较低的 BW 与极高的死亡率相关。黑人婴儿和男孩的生存率分别低于其他种族和女孩。较大的医院有更高的生存率，但医院位置、教学状态和类型均不影响生存率。付款人状态和收入四分位数均不影响生存率。
PDA 和 SL 在较低的 BW 和 GA 组中更为常见。在最低 BW 和 GA 组中，接受 SL 的婴儿的生存率高于未接受 SL 的婴儿。SL 时机不会影响发病率和死亡率。BW 而不是 GA 决定了接受 SL 的婴儿的生存率。
