Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
Department of Pediatrics, Division of Neonatology, Baylor College of Medicine, Houston, Texas, USA.
JPEN J Parenter Enteral Nutr. 2024 Jan;48(1):74-81. doi: 10.1002/jpen.2570. Epub 2023 Nov 19.
To determine variables associated with outcomes in infants with intestinal failure (IF) and ostomy following reanastomosis (RA).
A single-center, descriptive cohort study of 120 infants with IF and a stoma from January 2011 to December 2020 with subsequent RA during initial hospitalization. The primary outcome was achievement of enteral autonomy (EA) following RA. Other outcomes were duration of hospital stay, and mortality. Penalized logistic regression and linear regression were used for data analysis.
The median gestational age was 26 weeks, and the median birth weight was 890 g. Three infants died. The median duration between ostomy creation and RA was 80 days (interquartile range; 62.5, 100.5). For each additional day of discontinuity, the odds of EA decreased by 2% (odds ratio [OR] = 0.980; 95% confidence interval [CI]: 0.962, 0.999; P = 0.038), and death increased by 4.2% (OR = 1.042; 95% CI: 1.010, 1.075; P = 0.009). For each additional mL/kg/day of enteral feeds at RA, the odds of EA increased by 7.5% (OR = 1.075; 95% CI: 1.027, 1.126, P = 0.002) and duration of hospital stay decreased by 0.35 days (slope coefficient = -0.351; 95% CI: -0.540, -0.163; P < 0.001).
Shorter duration of intestinal discontinuity and enteral nutrition before RA could positively influence EA and duration of stay in infants with IF and ostomy following RA.
确定与再吻合（RA）后患有肠衰竭（IF）和造口术的婴儿结局相关的变量。
这是一项单中心、描述性队列研究，纳入了 2011 年 1 月至 2020 年 12 月期间在初始住院期间接受 RA 的 120 名 IF 合并造口术婴儿，主要结局是 RA 后实现肠内自主（EA）。其他结局包括住院时间和死亡率。使用惩罚逻辑回归和线性回归进行数据分析。
中位胎龄为 26 周，中位出生体重为 890g。3 名婴儿死亡。造口术与 RA 之间的中位时间为 80 天（四分位距；62.5，100.5）。每增加 1 天的中断，EA 的可能性降低 2%（优势比[OR] = 0.980；95%置信区间[CI]：0.962，0.999；P = 0.038），死亡风险增加 4.2%（OR = 1.042；95% CI：1.010，1.075；P = 0.009）。RA 时每增加 1 毫升/千克/天的肠内喂养量，EA 的可能性增加 7.5%（OR = 1.075；95% CI：1.027，1.126，P = 0.002），住院时间减少 0.35 天（斜率系数 = -0.351；95% CI：-0.540，-0.163；P < 0.001）。
RA 前肠中断和肠内营养时间较短，可能对 RA 后 IF 合并造口术婴儿的 EA 和住院时间产生积极影响。
