Pediatric Short Bowel Syndrome

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dc.contributor.author Btaiche, Imad
dc.contributor.author Spencer, Ariel
dc.contributor.author Neega, Andreea
dc.contributor.author West, Brady
dc.contributor.author Safran, Jared
dc.contributor.author Brown, Pamela
dc.contributor.author Kuzma-O'Reilly, Barbara
dc.contributor.author Teitelbaum, Daniel H.
dc.date.accessioned 2016-10-05T11:27:30Z
dc.date.available 2016-10-05T11:27:30Z
dc.date.copyright 2005 en_US
dc.date.issued 2016-10-05
dc.identifier.issn 0003-4932 en_US
dc.identifier.uri http://hdl.handle.net/10725/4506
dc.description.abstract 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. en_US
dc.language.iso en en_US
dc.title Pediatric Short Bowel Syndrome en_US
dc.type Article en_US
dc.description.version Published en_US
dc.title.subtitle Redefining Predictors of Success en_US
dc.author.school SOP en_US
dc.author.idnumber 201105289 en_US
dc.author.department Pharmacy Practice Department en_US
dc.description.embargo N/A en_US
dc.relation.journal Annals of Surgery en_US
dc.journal.volume 242 en_US
dc.journal.issue 3 en_US
dc.article.pages 403-412 en_US
dc.identifier.ctation 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. en_US
dc.author.email imad.btaiche@lau.edu.lb en_US
dc.identifier.tou http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php en_US
dc.identifier.url http://journals.lww.com/annalsofsurgery/Abstract/2005/09000/Pediatric_Short_Bowel_Syndrome__Redefining.11.aspx en_US

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