Necrotizing enterocolitis requiring surgery: Outcomes by intestinal location of disease in 4371 infants

Objective: The objective of this study was to determine whether the outcomes of infants with surgically managed necrotizing enterocolitis (NEC) differ according to whether the location of NEC is in the small bowel, large bowel, or both. Study Design: A retrospective analysis was performed using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample and Kids' Inpatient Database. A total of 5374 infants identified as having undergone surgical management of NEC were stratified by location of bowel affected as small bowel (SB) only, large bowel (LB) only, or both small and large bowel (SB&LB). The type of surgical operation performed was used as a proxy for the location of bowel affected. Results: Of the 5374 infants with a diagnosis of NEC, 4371 had an operation that allowed for stratification by location. The LB group (n = 963) fared the best in all outcomes. The SB group (n = 2126) had the longest length of stay and highest total hospital charges, and mortality was comparable with that of the SB&LB group (n = 1282). Conclusions: Mortality, length of stay, and total hospital charges varied according to location of bowel affected by NEC.