Neonatal necrotizing enterocolitis: a nine-year experience. II. Outcome assessment

Area of Science:

• Pediatrics
• Neonatal Medicine
• Surgical Gastroenterology

Background:

• Necrotizing enterocolitis (NEC) is a severe gastrointestinal disease in neonates.
• High mortality rates associated with NEC necessitate further research into prognostic factors and treatment outcomes.

Purpose of the Study:

• To assess mortality rates in patients with necrotizing enterocolitis.
• To evaluate the impact of surgical versus medical management on NEC outcomes.
• To identify clinical and laboratory factors associated with mortality in NEC.

Main Methods:

• Retrospective analysis of 123 patients diagnosed with necrotizing enterocolitis over a nine-year period.
• Comparison of mortality rates between surgically and medically managed patient cohorts.
• Analysis of clinical signs (hematochezia, abdominal distention, "septic" appearance) and laboratory findings (bacteremia, disseminated intravascular coagulation, peritonitis with ascites) as predictors of mortality.

Main Results:

• Overall mortality for necrotizing enterocolitis was 45%.
• No significant difference in mortality was observed between surgical (46%) and medical (54%) management groups, even with intestinal perforation.
• Patients presenting with "septic" signs, bacteremia, disseminated intravascular coagulation, or peritonitis with ascites exhibited significantly higher mortality rates compared to those with isolated hematochezia or abdominal distention.

Conclusions:

• Clinical presentation and specific complications like bacteremia and peritonitis are critical determinants of mortality in necrotizing enterocolitis.
• Surgical intervention did not significantly alter mortality outcomes compared to medical management in this cohort.
• Further investigation into early identification and management of high-risk NEC presentations is warranted.