Xiaofei Ma, Xiaolan Li, Yongjiang Jiang, Yunzhi Liu, Yueju Cai
Among preterm infants undergoing intestinal resection, no statistically significant differences in mortality or major postoperative outcomes were detected between treatment groups. However, clinician-determined treatment duration and residual confounding by indication preclude conclusions regarding equivalence or the clinical benefit of prolonged therapy.
BACKGROUND: Albumin infusion is commonly used in preterm infants following intestinal resection, but the optimal treatment duration remains unclear.
METHODS: This two-center retrospective cohort study included 102 preterm infants who underwent intestinal resection in China between 2018 and 2024. Infants were classified as receiving short-course (≤5 days, n = 69) or long-course (>5 days, n = 33) albumin therapy. The primary outcome was 90-day all-cause mortality. Multivariable regression analyses modeled treatment duration as a continuous variable and adjusted for measured covariates; sensitivity and subgroup analyses were performed.
RESULTS: No statistically significant differences were observed in measured baseline characteristics between the groups. Crude 90-day mortality was numerically higher in the long-course group than in the short-course group (15.2% vs. 4.3%). When treatment duration was modeled continuously, the adjusted odds ratio for mortality was 1.36 per additional treatment day (95% CI, 0.98-1.97; P = 0.063). No statistically significant differences were detected in secondary outcomes or analyses using alternative duration thresholds.
CONCLUSIONS: Among preterm infants undergoing intestinal resection, no statistically significant differences in mortality or major postoperative outcomes were detected between treatment groups. However, clinician-determined treatment duration and residual confounding by indication preclude conclusions regarding equivalence or the clinical benefit of prolonged therapy.
IMPACT: No statistically significant differences in mortality or major postoperative outcomes were detected between short-course (≤5 days) and long-course (>5 days) albumin therapy in preterm infants undergoing intestinal resection. Albumin treatment duration was determined by clinical status, and substantial residual confounding by indication cannot be excluded. These exploratory findings do not establish equivalence between treatment strategies and cannot determine whether prolonged albumin therapy provides clinical benefit.