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Updated: Oct 22, 2025
In Vitro Apical-Out Enteroid Model of Necrotizing Enterocolitis
Published on: June 8, 2022
Characteristics and outcomes of a multi-institution cohort of infants with necrotizing enterocolitis totalis
Allison T Rose1, Isabella Zaniletti2, Matthew T Santore3
1Division of Neonatology, Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, GA, USA. atrose@emory.edu.
Objective:
To characterize the presentation, management and outcomes of infants with necrotizing enterocolitis totalis (tNEC) vs surgical non-totalis NEC (sNEC).
Study Design:
This retrospective study identified infants undergoing surgery for NEC through The Children's Hospitals Neonatal Database. Demographic, surgical and mortality characteristics were compared.
Results:
Of 1059 infants, 161 (15.2%) had tNEC. Perinatal characteristics did not differ. tNEC infants were older and were less likely to have pneumoperitoneum at referral (5.6% vs 13.1%, p < 0.001) or intestinal perforation at surgery (38.5% vs 66.7%, p < 0.001). Infants with tNEC were more acidotic preoperatively (7.1, [IQR 7, 7.3] vs 7.3, [IQR 7.2, 7.4], p < 0.001). Mortality was 96.9% for tNEC and 26.5% for sNEC (p < 0.001). tNEC cases varied by center, accounting for 0-43% of all surgical NEC cases.
Conclusions:
Mortality is high for tNEC infants, who present at older age, with greater illness severity but are less likely to have intestinal perforation than sNEC infants.
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