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A simple presurgical necrotizing enterocolitis-mortality scoring system

Journal of Perinatology volume 26, pages 764–768 (2006)Cite this article

Abstract

Objective:

To assess the relationship between early laboratory parameters, disease severity, type of management (surgical or conservative) and outcome in necrotizing enterocolitis (NEC).

Study design:

Retrospective collection and analysis of data from infants treated in a single tertiary care center (1980 to 2002). Data were collected on disease severity (Bell stage), birth weight (BW), gestational age (GA) and pre-intervention laboratory parameters (leukocyte and platelet counts, hemoglobin, lactate, C-reactive protein).

Results:

Data from 128 infants were sufficient for analysis. Factors significantly associated with survival were Bell stage (P<0.05), lactate (P<0.05), BW and GA (P<0.01, P<0.001, respectively). From receiver operating characteristics curves, the highest predictive value resulted from a score with 0 to 8 points combining BW, Bell stage, lactate and platelet count (P<0.001). At a cutoff level of 4.5 sensitivity and specificity for predicting survival were 0.71 and 0.72, respectively.

Conclusion:

Some single parameters were associated with poor outcome in NEC. Optimal risk stratification was achieved by combining several parameters in a score.

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Acknowledgements

We thank Professor Dr F Zepp, Chairman of the Department of Pediatrics at the Johannes Gutenberg-University in Mainz, Germany for providing access to the ICU patient's records, and the DAAD (German Academic Exchange Office) for supporting Dr A Mungnirandr from Bangkok, Thailand for this scientific project during his clinical fellowship in Mainz.

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Authors and Affiliations

  1. Department of Surgical Pediatrics, Inselspital, University of Berne, Switzerland

    U Kessler, Z Zachariou & S Berger

  2. Division of Pediatric Surgery, Department of Surgery, Siriraj Hospital, Mahidol University, Bangkok, Thailand

    A Mungnirandr

  3. Division of Neonatology, Department of Pediatrics, Inselspital, University of Berne, Switzerland

    M Nelle

  4. Department of Anaesthesia, Royal Infirmary of Edinburgh, Edinburgh, UK

    A F Nimmo

Authors
  1. U Kessler
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  2. A Mungnirandr
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  3. M Nelle
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  4. A F Nimmo
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  5. Z Zachariou
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  6. S Berger
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Corresponding author

Correspondence to S Berger.

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Kessler, U., Mungnirandr, A., Nelle, M. et al. A simple presurgical necrotizing enterocolitis-mortality scoring system. J Perinatol 26, 764–768 (2006). https://doi.org/10.1038/sj.jp.7211613

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  • DOI: https://doi.org/10.1038/sj.jp.7211613

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