The DOI matches its Crossref record; 20 of the 20 references it cites were found in a registry or an index.
Pediatric Short Bowel Syndrome: Redefining Predictors of Success
Open accessAbstract
In Brief Objective: To determine predictors of survival and of weaning off parenteral nutrition (PN) in pediatric short bowel syndrome (SBS) patients. Summary Background Data: Pediatric SBS carries extensive morbidity and high mortality, but factors believed to predict survival or weaning from PN have been based on limited studies. This study reviews outcomes of a large number of SBS infants and identifies predictors of success. Methods: Multivariate Cox proportional hazards analysis was conducted on 80 pediatric SBS patients. Primary outcome was survival; secondary outcome was ability to wean off PN. Nonsignificant covariates were eliminated. P < 0.05 was considered significant. Results: Over a mean of 5.1 years of follow-up, survival was 58 of 80 (72.5%) and 51 weaned off PN (63.8%). Cholestasis (conjugated bilirubin ≥2.5 mg/dL) was the strongest predictor of mortality (relative risk [RR] 22.7, P = 0.005). Although absolute small bowel length was only slightly predictive, percentage of normal bowel length (for a given infant's gestational age) was strongly predictive of mortality (if <10% of normal length, RR of death was 5.7, P = 0.003) and of weaning PN (if ≥10% of normal, RR of weaning PN was 11.8, P = 0.001). Presence of the ileocecal valve (ICV) also strongly predicted weaning PN (RR 3.9, P < 0.0005); however, ICV was not predictive of survival. Conclusions: Cholestasis and age-adjusted small bowel length are the major predictors of mortality in pediatric SBS. Age-adjusted small bowel length and ICV are the major predictors of weaning from PN. These data permit better prediction of outcomes of pediatric SBS, which may help to direct future management of these challenging patients. A review of 80 pediatric short bowel syndrome patients demonstrated that cholestasis and age-adjusted bowel length, but not the ileocecal valve, are the main predictors of mortality. The combination of bowel length <10% of predicted and cholestasis results in such high mortality that early referral for intestinal transplantation should be considered.
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Cites
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Intestinal loop lengthening—A technique for increasing small intestinal length
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Neonatal short bowel syndrome: population-based estimates of incidence and mortality rates
Wales, P. W., de Silva, N., Kim, J., Lecce, L., To, T., & Moore, A. (2004) · Journal of Pediatric Surgery · doi:10.1016/j.jpedsurg.2004.01.036 · Cited by 371
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Short-bowel syndrome in children and adults
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Predicting the duration of dependence on parenteral nutrition after neonatal intestinal resection
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Surgical Approach to Short-Bowel Syndrome: Experience in a Population of 160 Patients
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Cited by
Intestinal Adaptation Following Resection
Tappenden, K. A. (2014) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607114525210 · Cited by 261
Finkbeiner, S. R., Freeman, J. J., Wieck, M. M., El-Nachef, W., Altheim, C. H., Tsai, Y.-H., Huang, S., Dyal, R., White, E. S., Grikscheit, T. C., et al. (2015) · Biology Open · doi:10.1242/bio.013235 · Cited by 174
Self-citationMeran, L., Massie, I., Campinoti, S., Weston, A. E., Gaifulina, R., Tullie, L., Faull, P., Orford, M., Kucharska, A., Baulies, A., et al. (2020) · Nature Medicine · doi:10.1038/s41591-020-1024-z · Cited by 143
Intestinal mucosal atrophy and adaptation
Shaw, D. (2012) · World Journal of Gastroenterology · doi:10.3748/wjg.v18.i44.6357 · Cited by 133
Building gut from scratch — progress and update of intestinal tissue engineering
Tullie, L., Jones, B. C., De Coppi, P., & Li, V. S. W. (2022) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-022-00586-x · Cited by 27
Metadata
- Authors
- Spencer, A. U., Neaga, A., West, B., Safran, J., Brown, P., Btaiche, I., Kuzma-O'Reilly, B., & Teitelbaum, D. H.
- Venue
- Annals of Surgery
- Published
- 2005-09
- Volume
- 242
- Issue
- 3
- Pages
- 403-412
- ISSN
- 0003-4932 (ISSN-L)
- OpenAlex
- W1997308810
- Cited by
- 332
- References
- 20
- FWCI
- 7.36
- Type
- journal article
- Language
- en
- Open access
- green
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