Clinical Factors Affecting Postoperative Mortality in Necrotizing Enterocolitis

Jo, Hong Jae; Cho, Yong Hoon; Kim, Hae Young

Abstract

PURPOSE: Necrotizing enterocolitis (NEC) is one of the most common surgical emergencies during the neonatal period. The aim of this study was to identify and assess the factors affecting the postoperative mortality in infants with NEC that require surgical treatment.
METHODS
The authors retrospectively reviewed 37 infants surgically treated, at the Department of Surgery, Pusan National University Hospital, between Jan. 2000 and Dec. 2004. The patients were divided two groups according to the clinical outcomes; the survival and non-survival groups. Eight variables, i.e., sex, gestational age, weight at birth and at the time of the first operation, weight change between birth and the time of the first operation, degree of clinical manifestations (as a modified Bell's stage), interval between the onset of symptoms and the time of the first operation, the extent of necrotic intestine and associated anomalies, were analyzed.
RESULTS
Among 37 infants, 6 expired (a mortality rate of 16.2%). The postoperative mortality was not affected by sex, gestational age, and the weight at birth and at the time of the first operation, weight change between birth and at the time of the first operation, degree of clinical manifestations and the interval between the onset of symptoms and the time of the first operation. However, the extent of necrotic intestine was associated with a significantly increased mortality (P=0.046).
CONCLUSION
These data suggest that the extent of necrotic intestine is the only statistically significant factor affecting the postoperative mortality in infants with NEC that require surgical treatment.