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Pediatric Surgery International

, Volume 34, Issue 5, pp 535–541 | Cite as

Comparison of abdominal radiographs and sonography in prognostic prediction of infants with necrotizing enterocolitis

  • Shuai Chen
  • Yuanjun Hu
  • Qinghua Liu
  • Xiaoying Li
  • Hefeng Wang
  • Kelai Wang
Original Article
  • 263 Downloads

Abstract

Purpose

The purpose of this study was to investigate the comparison of AR and AUS in predicting prognosis in infants with necrotizing enterocolitis.

Methods

All patients were diagnosed as NEC at the department of general surgery and neonatal surgery, Qilu children’s hospital between 1st, Jun, 2010 and 30th, Dec, 2016. The logistic regression analysis and the area under ROC curve (AUC)s were also used to compare the prognostic values of radiograph and sonograph for NEC.

Results

Throughout the study period, 86 preterm neonates were hospitalized with diagnosis of definite NEC. Among these patients, 39 infants (45.3%) required surgical treatment. After adjusting for competing sonographic factors, we identified that thick bowel wall (more than 2.5 mm) (p = 0.001, HR: 1.849), intramural gas (pneumatosis intestinalis) (p = 0.017, HR: 1.265), portal venous gas (p = 0.002, HR: 1.824), and reduced peristalsis (p = 0.021, HR: 1.544) were independent prognostic factors associated with NEC. After adjusting for competing radiographic factors, we identified that free peritoneal gas (p = 0.007, HR: 1.472), portal venous gas (p = 0.012, HR: 1.649), and dilatation and elongation (p = 0.025, HR: 1.327). Moreover, we found that the AUROC for AR logistic model was 0.745 (95% CI 0.629–0.812), which was significant lower than the AUS logistic model (AUROC: 0.857, 95% CI 0.802–0.946) for predicting prognosis of NEC.

Conclusions

In conclusion, we found that several radiographic and sonographic parameters were associated with the prognosis of patients with NEC. The AUS model based on the logistic regression analysis was significant superior to the AR model in the prognostic prediction of NEC.

Keywords

NEC Abdominal radiographs Abdominal sonography 

Notes

Author contributions

SC and KW designed research; YH, QL, XL, and HW conducted acquisition of data; JSC performed research and statistical analysis; SC and KW wrote the paper; and KW conducted a critical revision of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors who have taken part in this study declared that they have nothing to disclose regarding funding or conflict of interest with respect to this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the ethics committee of Qilu Children’s Hospital affiliated to Shandong University.

Informed consents

Written informed consents were obtained from the parents of the patients prior to the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Shuai Chen
    • 1
  • Yuanjun Hu
    • 1
  • Qinghua Liu
    • 2
  • Xiaoying Li
    • 1
  • Hefeng Wang
    • 1
  • Kelai Wang
    • 1
    • 3
  1. 1.Department of General surgery and Neonatal surgeryQilu Children’s Hospital affiliated to Shandong UniversityJinanChina
  2. 2.Department of UltrasoundQilu Children’s Hospital affiliated to Shandong UniversityJinanChina
  3. 3.Department of Pediatric SurgeryQilu Hospital affiliated to Shandong UniversityJinanChina

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