Abstract
Background
Necrotizing enterocolitis is a primary factor contributing to neonatal mortality in neonatal intensive care units. Among them, those who require surgical treatment have a higher mortality rate.
Methods
A cohort of 174 children diagnosed with NEC 2a + stage between 2012 and 2022 underwent a retrospective study. The children were divided into two groups: a surgical group (89 individuals), and a medical treatment group (85 individuals). Data extraction from patient records is used to analyze biochemical and clinical variables.
Results
In comparison to the medicine treatment group, the operation group had a lower gestational age (212 (203, 223) days, as opposed to 216(209, 229) days, P = 0.023).The prevalence of severe pneumonia in the surgical group was greater compared to the non-surgical group (87% versus 66%, P = 0.001). The operation group exhibited a lower hemoglobin level (145.86 ± 38.25 VS 159.69 ± 37.46, P = 0.017), along with a reduced platelet level (194 (128, 250) VS 229 (181, 281), P = 0.003). Severe pneumonia (OR = 3.364, 95% CI:1.420–7.966), decreased hemoglobin (OR = 0.988, 95% CI 0.978–0.997), and reduced platelet count (OR = 0.995, 95%CI: 0.991–0.999) were identified as separate risk factors for NEC. The mortality rate of children with NEC was significantly higher when surgical intervention was performed, which was found to be a separate risk factor for their mortality (OR = 7.881, 95% CI :(2.671–23.254), P < 0.001).
Conclusion
Our study suggests that infants with extremely low birth weight who have severe pneumonia have a higher likelihood of developing severe NEC that necessitates surgical intervention. This correlation could be due to the existence of intestinal ischemia and injury caused by hypoxia.