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Multicenter Study
. 2017 Jan 27:7:41149.
doi: 10.1038/srep41149.

A UK wide cohort study describing management and outcomes for infants with surgical Necrotising Enterocolitis

Benjamin Allin  1   2 , Anna-May Long  1   2 , Amit Gupta  3 , Marian Knight  1 , Kokila Lakhoo  2 ; British Association of Paediatric Surgeons Congenital Anomalies Surveillance System Necrotising Enterocolitis Collaboration
Collaborators, Affiliations
Multicenter Study

A UK wide cohort study describing management and outcomes for infants with surgical Necrotising Enterocolitis

Benjamin Allin et al. Sci Rep. .

Erratum in

Abstract

The Royal College of Surgeons have proposed using outcomes from necrotising enterocolitis (NEC) surgery for revalidation of neonatal surgeons. The aim of this study was therefore to calculate the number of infants in the UK/Ireland with surgical NEC and describe outcomes that could be used for national benchmarking and counselling of parents. A prospective nationwide cohort study of every infant requiring surgical intervention for NEC in the UK was conducted between 01/03/13 and 28/02/14. Primary outcome was mortality at 28-days. Secondary outcomes included discharge, post-operative complication, and TPN requirement. 236 infants were included, 43(18%) of whom died, and eight(3%) of whom were discharged prior to 28-days post decision to intervene surgically. Sixty infants who underwent laparotomy (27%) experienced a complication, and 67(35%) of those who were alive at 28 days were parenteral nutrition free. Following multi-variable modelling, presence of a non-cardiac congenital anomaly (aOR 5.17, 95% CI 1.9-14.1), abdominal wall erythema or discolouration at presentation (aOR 2.51, 95% CI 1.23-5.1), diagnosis of single intestinal perforation at laparotomy (aOR 3.1 95% CI 1.05-9.3), and necessity to perform a clip and drop procedure (aOR 30, 95% CI 3.9-237) were associated with increased 28-day mortality. These results can be used for national benchmarking and counselling of parents.

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Conflict of interest statement

The authors declare no competing financial interests.

Figures

Figure 1
Figure 1. Management of infants requiring surgical intervention for necrotising enterocolitis.
Figure 2
Figure 2. Association of pre-operative characteristics with 28-day mortality.
Figure 3
Figure 3. Association of key operative findings and management strategies with 28-day mortality.
See this image and copyright information in PMC

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