Pediatric Short Bowel Syndrome
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 b...
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| المؤلف الرئيسي: | |
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| مؤلفون آخرون: | , , , , , , |
| التنسيق: | article |
| منشور في: |
2005
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| الوصول للمادة أونلاين: | http://hdl.handle.net/10725/4506 http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php http://journals.lww.com/annalsofsurgery/Abstract/2005/09000/Pediatric_Short_Bowel_Syndrome__Redefining.11.aspx |
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| _version_ | 1864513463699636224 |
|---|---|
| author | Btaiche, Imad |
| author2 | Spencer, Ariel Neega, Andreea West, Brady Safran, Jared Brown, Pamela Kuzma-O'Reilly, Barbara Teitelbaum, Daniel H. |
| author2_role | author author author author author author author |
| author_facet | Btaiche, Imad Spencer, Ariel Neega, Andreea West, Brady Safran, Jared Brown, Pamela Kuzma-O'Reilly, Barbara Teitelbaum, Daniel H. |
| author_role | author |
| dc.creator.none.fl_str_mv | Btaiche, Imad Spencer, Ariel Neega, Andreea West, Brady Safran, Jared Brown, Pamela Kuzma-O'Reilly, Barbara Teitelbaum, Daniel H. |
| dc.date.none.fl_str_mv | 2005 2016-10-05T11:27:30Z 2016-10-05T11:27:30Z 2016-10-05 |
| dc.identifier.none.fl_str_mv | 0003-4932 http://hdl.handle.net/10725/4506 Spencer, A. U., Neaga, A., West, B., Safran, J., Brown, P., Btaiche, I., ... & Teitelbaum, D. H. (2005). Pediatric short bowel syndrome: redefining predictors of success. Annals of surgery, 242(3), 403-412. http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php http://journals.lww.com/annalsofsurgery/Abstract/2005/09000/Pediatric_Short_Bowel_Syndrome__Redefining.11.aspx |
| dc.language.none.fl_str_mv | en |
| dc.relation.none.fl_str_mv | Annals of Surgery |
| dc.rights.*.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.title.none.fl_str_mv | Pediatric Short Bowel Syndrome Redefining Predictors of Success |
| dc.type.none.fl_str_mv | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | 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. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | LAURepo_f60fe65bbbb6d815a6fbbde588bf7d26 |
| identifier_str_mv | 0003-4932 Spencer, A. U., Neaga, A., West, B., Safran, J., Brown, P., Btaiche, I., ... & Teitelbaum, D. H. (2005). Pediatric short bowel syndrome: redefining predictors of success. Annals of surgery, 242(3), 403-412. |
| language_invalid_str_mv | en |
| network_acronym_str | LAURepo |
| network_name_str | Lebanese American University repository |
| oai_identifier_str | oai:laur.lau.edu.lb:10725/4506 |
| publishDate | 2005 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| spelling | Pediatric Short Bowel SyndromeRedefining Predictors of SuccessBtaiche, ImadSpencer, ArielNeega, AndreeaWest, BradySafran, JaredBrown, PamelaKuzma-O'Reilly, BarbaraTeitelbaum, Daniel H.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.PublishedN/A2016-10-05T11:27:30Z2016-10-05T11:27:30Z20052016-10-05Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article0003-4932http://hdl.handle.net/10725/4506Spencer, A. U., Neaga, A., West, B., Safran, J., Brown, P., Btaiche, I., ... & Teitelbaum, D. H. (2005). Pediatric short bowel syndrome: redefining predictors of success. Annals of surgery, 242(3), 403-412.http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.phphttp://journals.lww.com/annalsofsurgery/Abstract/2005/09000/Pediatric_Short_Bowel_Syndrome__Redefining.11.aspxenAnnals of Surgeryinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/45062021-03-19T10:03:18Z |
| spellingShingle | Pediatric Short Bowel Syndrome Btaiche, Imad |
| status_str | publishedVersion |
| title | Pediatric Short Bowel Syndrome |
| title_full | Pediatric Short Bowel Syndrome |
| title_fullStr | Pediatric Short Bowel Syndrome |
| title_full_unstemmed | Pediatric Short Bowel Syndrome |
| title_short | Pediatric Short Bowel Syndrome |
| title_sort | Pediatric Short Bowel Syndrome |
| url | http://hdl.handle.net/10725/4506 http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php http://journals.lww.com/annalsofsurgery/Abstract/2005/09000/Pediatric_Short_Bowel_Syndrome__Redefining.11.aspx |