Risk factors and surgical outcomes in pediatric patients with congenital heart disease and ischemic colitis

被引:0
|
作者
Mokhaberi, N. [1 ]
Schneider, E. P. [2 ]
Aftzoglou, M. [3 ]
Hueners, I. [4 ]
Koerner, M. [1 ]
Armbrust, L. [1 ]
Biermann, D. [4 ]
Kozlik-Feldmann, R. [2 ]
Huebler, M. [4 ]
Reinshagen, K. [1 ,5 ]
Tomuschat, C. [1 ]
机构
[1] Univ Med Ctr Hamburg Eppendorf, Dept Pediat Surg, Hamburg, Germany
[2] Univ Med Ctr Hamburg Eppendorf, Univ Heart & Vasc Ctr Hamburg, Hamburg, Germany
[3] Norfolk & Norwich Univ Hosp, Dept Paediat Surg, Norwich, England
[4] Univ Med Ctr Hamburg Eppendorf, Univ Heart & Vasc Ctr, Dept Congenital & Pediat Heart Surg, Hamburg, Germany
[5] Univ Med Ctr Hamburg Eppendorf, German Ctr Child & Adolescent Hlth DZKJ, Partner Site Hamburg, Hamburg, Germany
关键词
Ischemic colitis; Congenital heart defect; Bowel ischemia; Pediatric; Necrotizing enterocolitis; NECROTIZING ENTEROCOLITIS; INFANTS;
D O I
10.1007/s00383-024-05950-3
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
IntroductionThis study investigates risk factors and surgical outcomes in pediatric patients with congenital heart defects (CHD) who develop ischemic colitis (IC). Previous research indicates a higher IC risk in very low birth weight neonates with CHD.MethodsA retrospective analysis compared an IC-CHD group to a CHD-only group. Key variables included gestational age, birth weight, multiple pregnancies, prematurity, APGAR scores, cardiac and surgical characteristics, Aristotle-Score, and mortality rates. Surgical outcomes such as bowel resection and stoma procedures were also evaluated.ResultsIC-CHD exhibited significantly lower gestational ages and birth weights, with higher rates of multiple pregnancies and prematurity. APGAR scores were notably lower. Cardiac and surgical data showed more frequent ECMO use and shorter cardiopulmonary bypass durations in the IC-CHD group. High rates of bowel resection highlighted severe gastrointestinal involvement. Mortality was significantly higher in IC-CHD with elevated Aristotle scores correlating with poorer outcomes.ConclusionGestational age, birth weight, and initial health status are critical in predicting IC risk and surgical outcomes in pediatric patients with CHD. The significantly higher mortality and complex surgical needs in the IC-CHD group underscore the necessity for vigilant monitoring and tailored interventions. Development of targeted therapeutic strategies adjustment for confounding factors in future studies is needed.
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页数:7
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