Simple Scoring System that Predicts the Need for Surgical Intervention in Infants with Necrotizing Enterocolitis

作者全名："Kang, Cailong; Zhang, Rensen; Wang, Guoyong; Li, Yao; Yan, Chengwei; Li, Fang; Guo, Chunbao"

作者地址："[Zhang, Rensen; Wang, Guoyong; Li, Yao] Chongqing Med Univ, Childrens Hosp, Dept Pediat Gen Surg, Chongqing, Peoples R China; [Kang, Cailong; Zhang, Rensen; Wang, Guoyong; Guo, Chunbao] Chongqing Med Univ, Women & Childrens Hosp, Dept Pediat Surg, 120 Longshan Rd, Chongqing, 401147, Peoples R China; [Kang, Cailong; Zhang, Rensen; Wang, Guoyong; Li, Yao; Guo, Chunbao] Chongqing Hlth Ctr Women & Children, Dept Pediat Surg, Chongqing, Peoples R China; [Li, Yao; Li, Fang] Chongqing Hlth Ctr Women & Children, Dept Neonatal Care, Chongqing, Peoples R China; [Yan, Chengwei] Chongqing Univ Three Gorges Hosp, Dept Pediat Gen Surg, Chongqing, Peoples R China"

通信作者："Guo, CB (通讯作者)，Chongqing Med Univ, Women & Childrens Hosp, Dept Pediat Surg, 120 Longshan Rd, Chongqing, 401147, Peoples R China."

来源：ARCHIVES OF MEDICAL RESEARCH

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000925858400001

JCR分区：Q1

影响因子：7.7

年份：2023

卷号：54

期号：1

开始页：37

结束页：44

文献类型：Article

关键词：Necrotizing enterocolitis (NEC); Scoring system; Surgical intervention; Bowel resec-tion

摘要："Background and Aims. It is difficult to identify those preterm infants who require surgical intervention. This study examined the predictive factors for bowel resection in infants with definitive and advanced necrotizing enterocolitis (NEC). We then developed a scoring system to better predict the need for surgical intervention. Methods. A total of 203 infants with modified Bell's stage 2 or higher NEC from January 2018-December 2020 were identified for this study. A retrospective study evaluated the association between several comprehensive variables and surgical intervention using a multiple logistic regression analysis, and then a scoring system was developed based on the sum of coefficients ( 3). Results. Of the 135 patients who met the inclusion criteria, 57 infants underwent a surgical intervention. The multivariable logistic regression analysis showed that birth weight (regression coefficient, 3= 1.30), PCT ( 3= 2.33), not having received enteral nutrition before the diagnosis of NEC ( 3 = 2.13), acidosis ( 3 = 1.57), respiratory alkalosis ( 3 = 2.42), hypokalemia ( 3= 2.14), peritonitis ( 3 = 2.87) and coagulation disorders ( 3 = 1.78) were associated with the occurrence of bowel resection. A scoring system ranging from 0-17 was developed based on the total coefficient obtained. It was found that a cut-off score of 5 may distinguish those infants needing surgical intervention from other infants with NEC. Conclusion. We successfully developed a clinical decision-making tool associated with the need for surgical intervention among infants with advanced NEC. The risk scoring system could accurately identify infants who would benefit from surgical intervention. (c) 2022 Instituto Mexicano del Seguro Social (IMSS). Published by Elsevier Inc. All rights reserved."

基金机构："National Natural Science Foundation of China [30973440, 30770950]; Key Project of the Chongqing Natural Science Foundation (CSTC) [2008BA0021, cstc2012jjA0155]; Chongqing Health Planning Commission of Research Fund [2016MSXM044]"

基金资助正文："We thank Dr. Siqi Yang for providing technical assistance and for insightful discussions during the preparation of the manuscript and Dr. Xiaoyong Zhang at the Wistar Institute for help with the linguistic revision of the manuscript. This study was supported by grants from the National Natural Science Foundation of China (Nos: 30973440 and 30770950) in the design of the study; the Key Project of the Chongqing Natural Science Foundation (CSTC, 2008BA0021, cstc2012jjA0155) for collection, analysis, and interpretation of data; and the Chongqing Health Planning Commission of Research Fund (No: 2016MSXM044) in writing the manuscript."