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Necrotizing enterocolitis: factors affecting mortality in 101 surgical cases.
Surgery
|October 1, 1984
Summary
Necrotizing enterocolitis (NEC) in infants is linked to prematurity and low birth weight. Factors like acidosis and portal vein air indicate severe disease, necessitating prompt surgical intervention for better survival rates.
Area of Science:
- Neonatalogy
- Pediatric Surgery
- Gastroenterology
Background:
- Necrotizing enterocolitis (NEC) is a severe gastrointestinal emergency in neonates.
- Identifying risk factors and predictors of mortality is crucial for timely intervention.
Purpose of the Study:
- To evaluate prenatal, perinatal, therapeutic, clinical, laboratory, radiographic, and operative factors associated with mortality in infants with NEC requiring surgery.
- To identify indicators for prompt surgical intervention.
Main Methods:
- Retrospective evaluation of 101 infants undergoing surgery for NEC.
- Analysis of various clinical and radiographic parameters in relation to mortality.
Main Results:
- Infants <28 weeks gestation and <1500 gm birth weight had higher mortality.
- Umbilical artery catheters, specific formulas, and aminophylline were associated with adverse outcomes.
- Persistent acidosis, oliguria, abdominal erythema, and portal vein air correlated with worse outcomes (71% mortality with portal vein air).
- Localized NEC had a 70% survival rate, while extensive disease (>95% mortality).
Conclusions:
- Prematurity, low birth weight, and specific therapeutic agents are risk factors for NEC mortality.
- Clinical signs (acidosis, oliguria, erythema) and radiographic findings (portal vein air) predict advanced disease.
- Prompt surgical intervention is recommended for infants with indicators of advanced NEC.