Otake K, et al. – Authors planned this study to assess clinical characteristics and primary surgical diagnoses associated with in–hospital death in pediatric surgical patients admitted to the neonatal intensive care unit (NICU) of a tertiary hospital. Findings demonstrated congenital diaphragmatic hernia (CDH), Necrotizing enterocolitis (NEC), and extremely low birth weight (ELBW) as independent predictive factors associated with in–hospital death of pediatric surgical patients in their NICU. This suggested the necessity for novel approaches for those conditions to improve the survival.

Methods

• Authors performed this retrospective study that included all patients admitted to their NICU for pediatric surgical diseases between January 2001 and December 2015.
• They undertook univariate and multivariate binary logistic regression to determine independent factors associated with in-hospital death.

Results

• Authors included 440 cases; 334 (83.5%) patients underwent one or more surgeries.
• 36 cases died (8.2%) while hospitalized in the NICU.
• Surgical diagnoses commonly identified were: intestinal atresia/stenosis, anorectal malformation, CDH, esophageal atresia, and urinary system disorder.
• NEC was observed associated with the highest mortality rate.
• Using logistic regression, ELBW (odds ratio (OR) = 6.594; P = 0.006), CDH (OR = 13.954; P < 0.001), and NEC (OR = 8.991; P = 0.049) predicted in-hospital death.