Neonatal necrotizing enterocolitis.
Necrotizing enterocolitis (NEC) remains a major cause of morbidity and death in neonates. The 30% to 50% mortality rate for NEC with perforation has not changed appreciably in the past 30 years. The critical relevant outcomes following NEC include survival, gastrointestinal function, and neurodevelopmental status. In each of these areas, initial anecdotal and case-series analysis has been followed by studies using more sophisticated methods of analysis. The single most important predictor of outcome, besides gestational age, is whether or not the disease has progressed to the point requiring surgical intervention. Patients with NEC requiring operation have a high mortality. Moreover, the vast majority of morbidity following NEC occurs in the patients who survive following operation. The purpose of this review is to examine the evolution of evidence regarding outcomes for patients with NEC and to provide an update on our current state of knowledge.
Henry
Marion C W
MC
Section of Pediatric Surgery, Yale University School of Medicine, New Haven, Connecticut 06520-8062, USA.
Moss
R Lawrence
RL
D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000209:etiology / Q000401:mortality; D020345:Enterocolitis, Necrotizing / Q000401:mortality / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000401:mortality / Q000601:surgery*; D007416:Intestinal Perforation / Q000401:mortality / Q000601:surgery; D017063:Outcome Assessment, Health Care; D010289:Parenteral Nutrition, Total; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D012307:Risk Factors; D012778:Short Bowel Syndrome / Q000209:etiology / Q000401:mortality; D016019:Survival Analysis