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Predictive factors for rapid progression in preterm neonates with necrotizing enterocolitis
Jiale Chen1, Weitao Zhong1, Longlong Hou1
1Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
Frontiers in Pediatrics
|January 26, 2023
Summary
Necrotizing enterocolitis (NEC) in preterm infants can progress rapidly, leading to higher mortality. A new predictive model identifies key risk factors like male sex and portal venous gas to flag high-risk neonates for closer monitoring.
Area of Science:
- Neonatal Medicine
- Gastroenterology
- Pediatric Surgery
Background:
- Necrotizing enterocolitis (NEC) is a severe gastrointestinal condition in neonates.
- Rapid progression of NEC leads to increased mortality and morbidity.
- Identifying neonates at risk for rapid NEC progression is crucial for timely intervention.
Purpose of the Study:
- To develop and validate a predictive model for rapid NEC progression in preterm neonates.
- To identify independent risk factors associated with rapid NEC progression.
Main Methods:
- Retrospective study of 216 preterm neonates with NEC.
- Definition of rapidly progressive NEC (RP-NEC) as requiring surgery or death within 48 hours.
- Analysis of demographic, perinatal, clinical, and radiographic data at NEC onset.
Main Results:
- Male sex, portal venous gas, low neutrophil count, and low pH were independent risk factors for RP-NEC.
- The mortality rate for RP-NEC was 32.8% compared to 3.28% for non-rapidly progressive NEC.
- The predictive model achieved an AUC of 0.801, with 83% specificity and 66% sensitivity.
Conclusions:
- Rapidly progressive NEC in preterm infants is associated with significantly higher mortality.
- The developed model effectively predicts rapid NEC progression.
- Close surveillance of neonates identified by the model is recommended.
