A Nomogram for Predicting Surgical Timing in Neonates with Necrotizing Enterocolitis.

Area of Science:

• Neonatal surgery
• Pediatric gastroenterology
• Clinical prediction modeling

Background:

• Necrotizing enterocolitis (NEC) is a severe gastrointestinal emergency in neonates.
• Accurate prediction of surgical risk in NEC is crucial for timely intervention.
• Current methods for predicting NEC surgical intervention require refinement.

Purpose of the Study:

• To identify surgical risk variables in necrotizing enterocolitis (NEC).
• To develop and validate a predictive nomogram model for NEC surgical intervention timing.
• To enhance early diagnosis and treatment planning for NEC.

Main Methods:

• Infants diagnosed with NEC were retrospectively analyzed.
• Clinical, laboratory, and radiological data were collected.
• LASSO and multivariate logistic regression were used to build a predictive nomogram, validated with ROC curves, calibration plots, and DCA.

Main Results:

• A nomogram incorporating hypothermia, absent bowel sounds, WBC count, CRP levels, pneumatosis intestinalis, and ascites was developed.
• The nomogram demonstrated moderate predictive value (AUC > 0.8) with good calibration and clinical utility.
• Key predictors for surgical intervention in NEC were identified.

Conclusions:

• A simple, reliable clinical nomogram can aid physicians in evaluating NEC patients.
• The model facilitates early identification and diagnosis of NEC patients requiring surgery.
• This tool offers significant clinical value for developing treatment strategies in NEC.