Associated factors for surgical management in preterm neonate with definite necrotizing enterocolitis
Keywords:
Associated factors, necrotizing enterocolitis, preterm, surgical interventionAbstract
Background: Necrotizing enterocolitis (NEC) is a devastating disease of gastrointestinal tract in premature infant. The early identification of predicting factors of NEC stage III with surgical intervention might lead to timely intervention and an improved prognosis.
Objective: To identify associated factors for predicting NEC stage III in premature infants with definite NEC.
Method: This retrospective study included 131 premature infants < 37 weeks gestation diagnosed with definite NEC at Maharat Nakhon Ratchasima Hospital between 1 January 2017 and 31 December 2021. Clinical characteristics, laboratory parameters, and clinical outcomes were collected. Multivariable logistic regression was performed to define predicting factors of NEC stage III.
Results: Of the 131 infants in this cohort, 38 infants were diagnosed with NEC stage III. The significant predicting factors of NEC stage III were the platelet count on the first day of diagnosis, with a cut-off value of < 100,000 /cu.mm. (OR 6.0, 95%CI 1.2 – 30.1), serum albumin on the first day of diagnosis, with a cut-off value of < 2.8 g/dL (OR 4.9, 95%CI 1.1 – 21.4), and APGAR score at 5 minutes < 7 (OR 8.5, 95%CI 1.1 – 69.7). The mortality rate in NEC stage III was 58%.
Conclusions: Associated factors of NEC stage III were thrombocytopenia and hypoalbuminemia on the first day of diagnosis and low APGAR score at 5 minutes.
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