Nomogram for predicting fulminant necrotizing enterocolitis.

Area of Science:

• Neonatal Medicine
• Pediatric Surgery
• Critical Care

Background:

• Fulminant necrotizing enterocolitis (FNEC) is a severe subtype of necrotizing enterocolitis (NEC) with high mortality and sequelae.
• Early prediction of FNEC onset is crucial for developing tailored treatment plans.
• This study focused on creating and validating a predictive tool for FNEC.

Purpose of the Study:

• To develop and evaluate a predictive nomogram for identifying neonates at risk of FNEC.
• To improve the accuracy of FNEC diagnosis and intervention timing.
• To provide a tool for individualized risk assessment in neonatal NEC cases.

Main Methods:

• Retrospective analysis of clinical data from 206 neonates diagnosed with NEC (Bell stage ≥ IIB).
• Development of a multivariate logistic regression model to construct the predictive nomogram.
• Performance evaluation using area under the curve (AUC), calibration, and decision curve analysis.

Main Results:

• 40 out of 206 neonates (19.4%) were diagnosed with FNEC.
• Key predictors identified include assisted ventilation, shock at onset, feeding volumes, and neutrophil, lymphocyte, and monocyte counts.
• The nomogram demonstrated strong discrimination (AUC = 0.884) and good calibration, confirming clinical utility.

Conclusions:

• A validated nomogram can effectively predict individualized FNEC risk in neonates.
• This tool supports earlier diagnosis and timely intervention for FNEC.
• The nomogram offers a promising approach for personalized management of severe NEC cases.