Abstract
Background and Aim: Necrotizing enterocolitis (NEC) is the most common serious, acquired gastrointestinal (GI) disorder affecting newborns. The aim of this study was to identify predictors of intestinal failure (IF) following NEC.
Design/Methods: Retrospective study of all neonates treated for NEC Stage II or greater, between 2000 and 2009 at the Hospital for Sick Children, Toronto, a tertiary referral NICU covering 65,000 births per year. Need for surgery, residual bowel length and rates of IF, defined as need for parenteral nutrition > 42 days after NEC and other outcomes were examined.
Results: In the 10 year period, 301 patients were treated for NEC. 71 (23%) died within 42 days of NEC diagnosis. In infants surviving >42 days 97/230 (42%) developed IF. There was a significant relationship between IF and gram negative bacteremia, cholestasis, liver failure and mortality. In the infants requiring surgery, mortality was highest in the peritoneal drain group (67%) compared to 34 % in the laparotomy group.
Conclusions: IF developed in 42% of infants following NEC and was fatal in 21/97 (22%). Predictors for IF are low birth weight, low gestational age, gram negative bacteremia, and need for surgical intervention.
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Elfvin, A., Wales, P. & Moore, A. Predictors of Intestinal Failure and Outcome Following Necrotizing Enterocolitis. Pediatr Res 70 (Suppl 5), 791 (2011). https://doi.org/10.1038/pr.2011.1016
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DOI: https://doi.org/10.1038/pr.2011.1016