{"doi":"10.1177/19345798241310112","title":"Association of timing of surgery and outcomes in preterm infants with surgical necrotizing enterocolitis and intestinal perforation","abstract":"Background: To investigate the association between the timing of surgery from the day of NEC/SIP diagnosis and clinical outcomes in preterm infants. Study Design: A retrospective cohort study comparing clinical outcomes of infants undergoing laparotomy at three clinically relevant time points (less and more than 48 hours, 96 hours, and 168 hours [7 days]) following NEC/SIP diagnosis. Results: Infants with NEC/SIP ( N = 97) receiving surgical invention >96 hours (34/97) had significantly lower gestational age (25.5 weeks [24.0; 26.9] vs 27.0 [25.0; 31.3]; p = 0.006), had lower birth weight (687 grams [600; 902] vs 940 [710; 1495]; p<0.001), had pneumoperitoneum less often on the abdominal x-ray (29.4% vs 57.1%, p = 0.017), had hemorrhagic ( p = 0.04) and reparative ( p = 0.003) lesions more often on intestinal histopathology, had PDA diagnosed more often (76.5% vs 50.8%, p = 0.02), required assisted ventilation more frequently ( p = 0.013), and received parenteral nutrition for longer duration (112 days [76.5; 145] vs 65.0 [23.0; 112], p = 0.004) following surgery compared to the infants receiving surgical intervention before 96 hours ( n = 63/97). In NEC-only sub-cohort, infants receiving laparotomy >48 hours ( n = 29/75) had lower median gestational age, lower birth weight, less pneumoperitoneum, and higher acute kidney injury than those receiving surgery <48 hours. On logistic regression, the odds of death were not significantly different (OR 0.65 [0.28, 1.54], p = 0.32) for infants receiving laparotomy ≤48 hours following NEC/SIP compared to subjects undergoing surgery >48 hours. The odds of intestinal failure (>60 days of parenteral nutrition) were 4.5 times (CI 1.56, 14.3), p = 0.005) higher for those having surgery >96 hours from NEC/SIP diagnosis. Conclusion: There was no significant difference in death among infants receiving surgery within 48 hours following surgical NEC/SIP diagnosis compared to those receiving surgery at ≥ 48 hours of diagnosis. However, infants receiving surgery >96 hours were more likely to receive parenteral nutrition for longer time. A prospective study is needed to understand the continuous relationship between time to surgery and outcomes.","journal":"Journal of Neonatal-Perinatal Medicine","year":2024,"id":456995,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":6,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9617,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1113910,"name":"Robin Riddick","orcid":null,"position":2,"is_corresponding":false},{"id":965759,"name":"Md Abu Yusuf Ansari","orcid":"0000-0001-9076-9320","position":3,"is_corresponding":false},{"id":874598,"name":"Joe Yi","orcid":null,"position":4,"is_corresponding":false},{"id":1113148,"name":"Isabella Pittman","orcid":null,"position":5,"is_corresponding":false},{"id":1113911,"name":"Peter J. Porcelli","orcid":null,"position":6,"is_corresponding":false},{"id":919830,"name":"Neha Varshney","orcid":"0000-0003-4065-1521","position":7,"is_corresponding":false},{"id":1113370,"name":"David Sawaya","orcid":"0000-0003-1929-6051","position":8,"is_corresponding":false},{"id":874194,"name":"Jeffrey Shenberger","orcid":"0000-0003-4845-0847","position":9,"is_corresponding":false},{"id":49897,"name":"William B. Hillegass","orcid":"0000-0001-6428-0564","position":10,"is_corresponding":false},{"id":1282765,"name":"Padma P Garg","orcid":null,"position":11,"is_corresponding":false},{"id":400551,"name":"Parvesh Mohan Garg","orcid":"0000-0001-5949-7304","position":0,"is_corresponding":true}],"reference_count":30,"raw_metadata":null,"created_at":"2026-07-19T02:03:37.136946Z","pmid":"40016977","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}