Abdominal ultrasound findings contribute to a multivariable predictive risk score for surgical necrotizing enterocolitis: A pilot study.
Abdomen
/ diagnostic imaging
Abdominal Wall
/ diagnostic imaging
Area Under Curve
Enterocolitis, Necrotizing
/ diagnostic imaging
Erythema
/ complications
Female
Humans
Infant, Newborn
Infant, Newborn, Diseases
/ diagnostic imaging
Logistic Models
Male
Pilot Projects
Radiography
Retrospective Studies
Risk Assessment
/ methods
Risk Factors
Ultrasonography
Abdominal radiograph
Abdominal ultrasound
Necrotizing enterocolitis
Predictors
Risk score
Surgical NEC
Journal
American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
received:
20
01
2021
revised:
04
04
2021
accepted:
19
04
2021
pubmed:
8
5
2021
medline:
22
12
2021
entrez:
7
5
2021
Statut:
ppublish
Résumé
Abdominal ultrasound (AUS) is a promising adjunct to abdominal x-ray (AXR) for evaluating necrotizing enterocolitis (NEC). We developed a multivariable risk score incorporating AUS to predict surgical NEC. 83 patients were evaluated by AXR and AUS for suspected NEC. A subset had surgical NEC. Multivariate logistic regression determined predictors of surgical NEC, which were incorporated into a risk score. 14/83 patients (16.9%) had surgical NEC. 10/83 (12.0%) patients required acute intervention, while 4/83 (4.8%) patients only required delayed surgery. Four predictors of surgical NEC were identified: abdominal wall erythema (OR: 8.2, p = 0.048), portal venous gas on AXR (OR: 29.8, p = 0.014), and echogenic free fluid (OR: 17.2, p = 0.027) and bowel wall thickening (OR: 12.5, p = 0.030) on AUS. A multivariable risk score incorporating these predictors had excellent area-under-the-curve of 0.937 (95% CI: 0.879-0.994). AUS, as an adjunct to physical exam and AXR, has utility for predicting surgical NEC.
Sections du résumé
BACKGROUND
BACKGROUND
Abdominal ultrasound (AUS) is a promising adjunct to abdominal x-ray (AXR) for evaluating necrotizing enterocolitis (NEC). We developed a multivariable risk score incorporating AUS to predict surgical NEC.
METHODS
METHODS
83 patients were evaluated by AXR and AUS for suspected NEC. A subset had surgical NEC. Multivariate logistic regression determined predictors of surgical NEC, which were incorporated into a risk score.
RESULTS
RESULTS
14/83 patients (16.9%) had surgical NEC. 10/83 (12.0%) patients required acute intervention, while 4/83 (4.8%) patients only required delayed surgery. Four predictors of surgical NEC were identified: abdominal wall erythema (OR: 8.2, p = 0.048), portal venous gas on AXR (OR: 29.8, p = 0.014), and echogenic free fluid (OR: 17.2, p = 0.027) and bowel wall thickening (OR: 12.5, p = 0.030) on AUS. A multivariable risk score incorporating these predictors had excellent area-under-the-curve of 0.937 (95% CI: 0.879-0.994).
CONCLUSIONS
CONCLUSIONS
AUS, as an adjunct to physical exam and AXR, has utility for predicting surgical NEC.
Identifiants
pubmed: 33958200
pii: S0002-9610(21)00275-0
doi: 10.1016/j.amjsurg.2021.04.025
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1034-1039Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.