A simple presurgical necrotizing enterocolitis-mortality scoring system

• Published in: Journal of Perinatology Vol. 26; no. 12; pp. 764 - 768
• Main Authors: Kessler, U, Mungnirandr, A, Nelle, M, Nimmo, A F, Zachariou, Z, Berger, S
• Format: Journal Article
• Language: English
• Published: United States Nature Publishing Group 01-12-2006
• Subjects: Birth Weight; Blood; Blood platelets; C-reactive protein; Decision making; Enterocolitis; Enterocolitis, Necrotizing - blood; Enterocolitis, Necrotizing - classification; Enterocolitis, Necrotizing - mortality; Enterocolitis, Necrotizing - therapy; Female; Gastrointestinal diseases; Gestational Age; Hemoglobin; Hospitals; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases - classification; Infant, Premature, Diseases - mortality; Infant, Premature, Diseases - therapy; Infants; Laboratories; Lactic acid; Lactic Acid - blood; Leukocytes; Male; Medical prognosis; Mortality; Necrosis; Necrotizing enterocolitis; Parameters; Pediatrics; Platelets; Retrospective Studies; ROC Curve; Sensitivity and Specificity; Severity of Illness Index; Surgery; Survival; Survival Analysis; United Kingdom > UK; Switzerland; Germany
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/sj.jp.7211613

To assess the relationship between early laboratory parameters, disease severity, type of management (surgical or conservative) and outcome in necrotizing enterocolitis (NEC).
Retrospective collection and analysis of data from infants treated in a single tertiary care center (1980 to 2002). Data were collected on disease severity (Bell stage), birth weight (BW), gestational age (GA) and pre-intervention laboratory parameters (leukocyte and platelet counts, hemoglobin, lactate, C-reactive protein).
Data from 128 infants were sufficient for analysis. Factors significantly associated with survival were Bell stage (P<0.05), lactate (P<0.05), BW and GA (P<0.01, P<0.001, respectively). From receiver operating characteristics curves, the highest predictive value resulted from a score with 0 to 8 points combining BW, Bell stage, lactate and platelet count (P<0.001). At a cutoff level of 4.5 sensitivity and specificity for predicting survival were 0.71 and 0.72, respectively.
Some single parameters were associated with poor outcome in NEC. Optimal risk stratification was achieved by combining several parameters in a score.