Development of a multivariable prediction model for necrotizing enterocolitis stage III or mortality within a week among preterm infants at the time of initial evaluation for necrotizing enterocolitis: A retrospective cohort study

Abstract

Abstract Objective: This study was designed to develop a multivariate prediction model using variables obtained at the time of sepsis evaluation to predict necrotizing enterocolitis (NEC) stage III or death within a week with an area under the curve (AUC)>0.90. Study design: This is a retrospective cohort study (n=269) of preterm infants <33 weeks' gestation or <1500 grams birthweight either suspected or with NEC born at Parkland Health between 2009-2021. A multivariate prediction model using the new PACSOFAH score (Pneumoperitoneum, Abdominal Compartment Syndrome, Neonatal Sequential Organ failure Assessment (NSOFA) score, acidemia, hyperkalemia, hyperglycemia), gestational age and use of inotropes for hypotension during the prior week was compared with a similar model using NSOFA score. Results: The PACSOFAH-model had a greater AUC than the NSOFA-model (0.92 vs 0.85, respectively, P=0.0005). Conclusion: A new prediction model for death or NEC stage III was developed with AUC=0.92 at the time of initial sepsis evaluation.