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A simple presurgical necrotizing enterocolitis-mortality scoring system
U Kessler1, A Mungnirandr, M Nelle
1Department of Surgical Pediatrics, Inselspital, University of Berne, Switzerland.
Objective:
To assess the relationship between early laboratory parameters, disease severity, type of management (surgical or conservative) and outcome in necrotizing enterocolitis (NEC).
Study Design:
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).
Results:
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.
Conclusion:
Some single parameters were associated with poor outcome in NEC. Optimal risk stratification was achieved by combining several parameters in a score.
