Advanced necrotizing enterocolitis part 1: mortality

Thyoka, M., de Coppi, P., Eaton, S., Khoo, K., Hall, N.J, Curry, J., Kiely, E., Drake, D., Cross, K. and Pierro, A. (2012) Advanced necrotizing enterocolitis part 1: mortality. European Journal of Pediatric Surgery, 22 (1), 8-12. (doi:10.1055/s-0032-1306263). (PMID:22434227)

Abstract

Aim of the study: the aim of this study was to investigate the factors associated with mortality in infants referred for the surgical treatment of advanced necrotizing enterocolitis (NEC).

Methods: retrospective review of all infants with confirmed (Bell stage II or III) NEC treated in our unit during the past 8 years (January 2002 to December 2010). Data for survivors and nonsurvivors were compared using Mann-Whitney test and Fisher's exact test and are reported as median (range).

Results: of the 205 infants with NEC, 35 (17%) were medically managed; 170 (83%) had surgery; 66 (32%) infants died; all had received surgery. Survivors and nonsurvivors were comparable for gestational age, birth weight, and gender distribution. Overall mortality was 32%, the highest mortality was in infants with pan-intestinal disease (86%) but remained significant in those with less severe disease (multifocal 39%; focal disease 21%). The commonest cause of mortality was multiple organ dysfunction syndrome and nearly half of the nonsurvivors had care withdrawn.

Conclusion: despite improvement in neonatal care, overall mortality (32%) for advanced NEC has not changed in 10 years. Mortality is significant even with minimal bowel involvement

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Contributors

Author: N.J Hall

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