Predictive factors related to surgical decision-making in neonates with necrotizing enterocolitis

Necrotizing enterocolitis (NEC) is more common in neonates. This study aimed to determine the predictive factors in the decision-making about surgery in neonates with NEC.

This retrospective cohort study was performed in Ali Asghar Children's Hospital in Tehran, Iran. All neonates hospitalized due to NEC from 2018 to 2020 were enrolled in this study. We compared the study variables such as demographic, clinical, laboratory, radiography, and sonography variables in neonates who underwent surgery with neonates without surgery. Statistical analysis was conducted by SPSS and R software.

There was no statistically significant difference between the two groups regarding age at hospitalization, sex, gestational age, and birth weight (P > 0.05). Comparison of laboratory, clinical, and radiography findings showed that there were significant statistical differences in terms of C-reactive protein (CRP), prothrombin time (PT), international normalized ratio (INR), sodium (Na), procalcitonin (PCT), skin discoloration of the abdominal wall, presence of portal venous gas (PVG), pneumoperitoneum, ascites, and fixed intestinal loop between two groups (P < 0.05). The results also showed that existence of skin discoloration of the abdominal wall, high level of CRP, PVG, pneumoperitoneum, ascites, and fixed intestinal loop were predictive factors for the decision of surgery.

The abdominal color change, high level of CRP, PVG, pneumoperitoneum, ascites, and fixed intestinal loop are predictive factors for the decision of surgery in neonates with NEC.