Factors affecting survival in surgically treated neonates with necrotizing enterocolitis

ABSTRACT

Necrotizing enterocolitis [NEC] is a life threatening disease of stressed neonates that is more common in low-birth weight [LBW] and preterm infants. It is considered as the most devastating gastrointestinal emergency in newborn infants. As more premature infants with NEC survive, the morbidity, mortality, functional outcome and prognosis in neonates with NEC have become a subject of great interest. The aim of this study is to identify mortality predictive factors in neonates with NEC who required surgical intervention. The study was conducted at Cairo University Children Hospital [CUCH] during the period from May 2001 to June 2003. Forty one patients with NEC requiring exploratory laparotomy were studied. Patients underwent follow-up for 90 days after the procedure. Certain variables have been taken into consideration as predictive factors for mortality. These variables were Weight at birth, Gestational age, Sex, Presence of sepsis, Type of feeding, Gas in the peritoneal cavity at abdominal x-ray, Extent of disease, operative strategy [Resection and anastomosis or resection and enterostomy], and extent of bowel resection [ileocecal valve retained or removed]. Database configuration and analysis was performed with Microsoft access and statistical analysis was performed with the use of X2-analysis and the student t-test for paired groups using two tailed comparisons with P-value less than 0.05 considered statistically significant. Statistical analysis revealed that mortality was significantly higher with pan intestinal disease, weight less than 1.8 kg and gestational age less than 30 weeks