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Predictive factors for surgical treatment in preterm neonates with necrotizing enterocolitis: a multicenter case-control study

Necrotizing enterocolitis (NEC) is one of the most common and lethal gastrointestinal diseases in preterm infants. Early recognition of infants in need for surgical intervention might enable early intervention. In this multicenter case-control study, performed in nine neonatal intensive care units,...

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Autores principales: el Manouni el Hassani, Sofia, Niemarkt, Hendrik J., Derikx, Joep P. M., Berkhout, Daniel J. C., Ballón, Andrea E., de Graaf, Margot, de Boode, Willem P., Cossey, Veerle, Hulzebos, Christian V., van Kaam, Anton H., Kramer, Boris W., van Lingen, Richard A., Vijlbrief, Daniel C., van Weissenbruch, Mirjam M., Benninga, Marc A., de Boer, Nanne K. H., de Meij, Tim G. J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7813726/
https://www.ncbi.nlm.nih.gov/pubmed/33269424
http://dx.doi.org/10.1007/s00431-020-03892-1
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author el Manouni el Hassani, Sofia
Niemarkt, Hendrik J.
Derikx, Joep P. M.
Berkhout, Daniel J. C.
Ballón, Andrea E.
de Graaf, Margot
de Boode, Willem P.
Cossey, Veerle
Hulzebos, Christian V.
van Kaam, Anton H.
Kramer, Boris W.
van Lingen, Richard A.
Vijlbrief, Daniel C.
van Weissenbruch, Mirjam M.
Benninga, Marc A.
de Boer, Nanne K. H.
de Meij, Tim G. J.
author_facet el Manouni el Hassani, Sofia
Niemarkt, Hendrik J.
Derikx, Joep P. M.
Berkhout, Daniel J. C.
Ballón, Andrea E.
de Graaf, Margot
de Boode, Willem P.
Cossey, Veerle
Hulzebos, Christian V.
van Kaam, Anton H.
Kramer, Boris W.
van Lingen, Richard A.
Vijlbrief, Daniel C.
van Weissenbruch, Mirjam M.
Benninga, Marc A.
de Boer, Nanne K. H.
de Meij, Tim G. J.
author_sort el Manouni el Hassani, Sofia
collection PubMed
description Necrotizing enterocolitis (NEC) is one of the most common and lethal gastrointestinal diseases in preterm infants. Early recognition of infants in need for surgical intervention might enable early intervention. In this multicenter case-control study, performed in nine neonatal intensive care units, preterm born infants (< 30 weeks of gestation) diagnosed with NEC (stage ≥ IIA) between October 2014 and August 2017 were divided into two groups: (1) medical (conservative treatment) and (2) surgical NEC (sNEC). Perinatal, clinical, and laboratory parameters were collected daily up to clinical onset of NEC. Univariate and multivariate logistic regression analyses were applied to identify potential predictors for sNEC. In total, 73 preterm infants with NEC (41 surgical and 32 medical NEC) were included. A low gestational age (p value, adjusted odds ratio [95%CI]; 0.001, 0.91 [0.86–0.96]), no maternal corticosteroid administration (0.025, 0.19 [0.04–0.82]), early onset of NEC (0.003, 0.85 [0.77–0.95]), low serum bicarbonate (0.009, 0.85 [0.76–0.96]), and a hemodynamically significant patent ductus arteriosus for which ibuprofen was administered (0.003, 7.60 [2.03–28.47]) were identified as independent risk factors for sNEC. Conclusions: Our findings may support the clinician to identify infants with increased risk for sNEC, which may facilitate early decisive management and consequently could result in improved prognosis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00431-020-03892-1.
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spelling pubmed-78137262021-01-25 Predictive factors for surgical treatment in preterm neonates with necrotizing enterocolitis: a multicenter case-control study el Manouni el Hassani, Sofia Niemarkt, Hendrik J. Derikx, Joep P. M. Berkhout, Daniel J. C. Ballón, Andrea E. de Graaf, Margot de Boode, Willem P. Cossey, Veerle Hulzebos, Christian V. van Kaam, Anton H. Kramer, Boris W. van Lingen, Richard A. Vijlbrief, Daniel C. van Weissenbruch, Mirjam M. Benninga, Marc A. de Boer, Nanne K. H. de Meij, Tim G. J. Eur J Pediatr Original Article Necrotizing enterocolitis (NEC) is one of the most common and lethal gastrointestinal diseases in preterm infants. Early recognition of infants in need for surgical intervention might enable early intervention. In this multicenter case-control study, performed in nine neonatal intensive care units, preterm born infants (< 30 weeks of gestation) diagnosed with NEC (stage ≥ IIA) between October 2014 and August 2017 were divided into two groups: (1) medical (conservative treatment) and (2) surgical NEC (sNEC). Perinatal, clinical, and laboratory parameters were collected daily up to clinical onset of NEC. Univariate and multivariate logistic regression analyses were applied to identify potential predictors for sNEC. In total, 73 preterm infants with NEC (41 surgical and 32 medical NEC) were included. A low gestational age (p value, adjusted odds ratio [95%CI]; 0.001, 0.91 [0.86–0.96]), no maternal corticosteroid administration (0.025, 0.19 [0.04–0.82]), early onset of NEC (0.003, 0.85 [0.77–0.95]), low serum bicarbonate (0.009, 0.85 [0.76–0.96]), and a hemodynamically significant patent ductus arteriosus for which ibuprofen was administered (0.003, 7.60 [2.03–28.47]) were identified as independent risk factors for sNEC. Conclusions: Our findings may support the clinician to identify infants with increased risk for sNEC, which may facilitate early decisive management and consequently could result in improved prognosis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00431-020-03892-1. Springer Berlin Heidelberg 2020-12-02 2021 /pmc/articles/PMC7813726/ /pubmed/33269424 http://dx.doi.org/10.1007/s00431-020-03892-1 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Article
el Manouni el Hassani, Sofia
Niemarkt, Hendrik J.
Derikx, Joep P. M.
Berkhout, Daniel J. C.
Ballón, Andrea E.
de Graaf, Margot
de Boode, Willem P.
Cossey, Veerle
Hulzebos, Christian V.
van Kaam, Anton H.
Kramer, Boris W.
van Lingen, Richard A.
Vijlbrief, Daniel C.
van Weissenbruch, Mirjam M.
Benninga, Marc A.
de Boer, Nanne K. H.
de Meij, Tim G. J.
Predictive factors for surgical treatment in preterm neonates with necrotizing enterocolitis: a multicenter case-control study
title Predictive factors for surgical treatment in preterm neonates with necrotizing enterocolitis: a multicenter case-control study
title_full Predictive factors for surgical treatment in preterm neonates with necrotizing enterocolitis: a multicenter case-control study
title_fullStr Predictive factors for surgical treatment in preterm neonates with necrotizing enterocolitis: a multicenter case-control study
title_full_unstemmed Predictive factors for surgical treatment in preterm neonates with necrotizing enterocolitis: a multicenter case-control study
title_short Predictive factors for surgical treatment in preterm neonates with necrotizing enterocolitis: a multicenter case-control study
title_sort predictive factors for surgical treatment in preterm neonates with necrotizing enterocolitis: a multicenter case-control study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7813726/
https://www.ncbi.nlm.nih.gov/pubmed/33269424
http://dx.doi.org/10.1007/s00431-020-03892-1
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