Neonatal independent predictors of severe NEC View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-04-11

AUTHORS

Miriam Duci, Francesco Fascetti-Leon, Marta Erculiani, Elena Priante, Maria Elena Cavicchiolo, Giovanna Verlato, Piergiorgio Gamba

ABSTRACT

PurposeNecrotizing enterocolitis (NEC) is a severe neonatal disease. The present study aimed to identify factors predisposing the development of severe forms of NEC.MethodsThis retrospective study examined NEC patients in a single centre between 2002 and 2015. Data concerning clinical characteristics, therapeutic management as well as short-term outcomes were collected. We compared the patients receiving successful medical treatment and those requiring surgical intervention. Patients who underwent surgery were distinguished in three subcategories. Bivariate and multivariate analyses were used for the statistical analysis.ResultsWe identified 155 patients in the study period. 102 were treated conservatively and 53 required surgery. 8 received a primary peritoneal drainage, 31 received a drainage and a subsequent laparotomy and 14 received a laparotomy. Multivariate regression analysis identified a lower risk for surgery with a later onset and higher serum pH values, whereas an increased risk with higher C reactive Protein (CRP) levels at the onset. Pneumatosis intestinalis was identified as a protective factor. Overall mortality was 6.4%, with higher percentage in surgical NEC.ConclusionThis study suggests that a later onset is a protective sign for the progression to surgery, whereas lower pH values and higher CRP levels are prognostic factors associated with the need for surgery. The line of treatment involving explorative laparotomy in case of perforation seems to be rewarded by low morbidity and mortality rate. More... »

PAGES

663-669

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00383-018-4261-1

DOI

http://dx.doi.org/10.1007/s00383-018-4261-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1103232293

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29644455


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