Neonatal independent predictors of severe NEC

  • Miriam Duci
  • Francesco Fascetti-Leon
  • Marta Erculiani
  • Elena Priante
  • Maria Elena Cavicchiolo
  • Giovanna Verlato
  • Piergiorgio Gamba
Original Article
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Abstract

Purpose

Necrotizing enterocolitis (NEC) is a severe neonatal disease. The present study aimed to identify factors predisposing the development of severe forms of NEC.

Methods

This 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.

Results

We 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.

Conclusion

This 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.

Keywords

Necrotizing enterocolitis Intestinal perforation Premature Prognostic factors Laparotomy Peritoneal drainage 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human and animal rights statement

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

Informed consent for the usage of anonymized data was obtained from all individual participants included in the study.

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Copyright information

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

Authors and Affiliations

  • Miriam Duci
    • 1
  • Francesco Fascetti-Leon
    • 1
  • Marta Erculiani
    • 1
  • Elena Priante
    • 2
  • Maria Elena Cavicchiolo
    • 2
  • Giovanna Verlato
    • 2
  • Piergiorgio Gamba
    • 1
  1. 1.Division of Paediatric Surgery, Department of ‘Salute della Donna e del Bambino’University of PadovaPadovaItaly
  2. 2.Division on Neonatal Intensive Care Unit, Department of ‘Salute della Donna e del Bambino’University of PadovaPadovaItaly

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