Advanced Necrotizing Enterocolitis Part 1: Mortality

M. Thyoka; P. de Coppi; S. Eaton; K. Khoo; N. J. Hall; J. Curry; E. Kiely; D. Drake; K. Cross; A. Pierro

doi:10.1055/s-0032-1306263

European Journal of Pediatric Surgery, Inhaltsverzeichnis

Eur J Pediatr Surg 2012; 22(01): 008-012
DOI: 10.1055/s-0032-1306263

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Advanced Necrotizing Enterocolitis Part 1: Mortality

Authors

M. Thyoka

¹Department of Surgery, Great Ormond Street Hospital and UCL Institute of Child Health, London, United Kingdom
P. de Coppi

¹Department of Surgery, Great Ormond Street Hospital and UCL Institute of Child Health, London, United Kingdom
S. Eaton

¹Department of Surgery, Great Ormond Street Hospital and UCL Institute of Child Health, London, United Kingdom
K. Khoo

¹Department of Surgery, Great Ormond Street Hospital and UCL Institute of Child Health, London, United Kingdom
N. J. Hall

¹Department of Surgery, Great Ormond Street Hospital and UCL Institute of Child Health, London, United Kingdom
J. Curry

¹Department of Surgery, Great Ormond Street Hospital and UCL Institute of Child Health, London, United Kingdom
E. Kiely

¹Department of Surgery, Great Ormond Street Hospital and UCL Institute of Child Health, London, United Kingdom
D. Drake

¹Department of Surgery, Great Ormond Street Hospital and UCL Institute of Child Health, London, United Kingdom
K. Cross

¹Department of Surgery, Great Ormond Street Hospital and UCL Institute of Child Health, London, United Kingdom
A. Pierro

¹Department of Surgery, Great Ormond Street Hospital and UCL Institute of Child Health, London, United Kingdom

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.

Keywords

necrotizing enterocolitis - mortality - multiple organ dysfunction syndrome

Volltext

Referenzen

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