National prospective surveillance study of necrotizing enterocolitis in neonatal intensive care units.
OBJECTIVE
There is scant epidemiological data on necrotizing enterocolitis (NEC), so we conducted a national study to characterize prevalence, surgical management, and mortality.


METHODS
A prospective cross-sectional survey was performed in the United Kingdom requesting data from 158 level 2 and 3 neonatal intensive care units (NICUs) during 2 winter and 2 summer months in 2005 to 2006; 51% of questionnaires were returned. Results are given as percentage with 95% confidence intervals.


RESULTS
(1) Period prevalence: 211 infants were diagnosed with NEC (45% Bell's stage I, 21% stage II, and 33% stage III) from a total of 10,946 NICU admissions, with a period prevalence of 2% (1.7-2.2). In infants less than 1000 g birth weight, the prevalence was 14% (12-16), and in less than 26 weeks of gestation, 14% (11-17). Prevalence decreased significantly with increasing birth weight (P < .0001) and increasing gestation (P < .0001). (2) SURGERY: 66 infants received surgical procedures; peritoneal drain in 13 (followed by laparotomy in 8) and in 53, laparotomy alone. (3) Mortality: 27 infants died with NEC of a total 283 deaths, thus, accounting for 9.5% of NICU mortality. Eight (30%) infants with NEC died without surgery.


CONCLUSIONS
Prevalence of NEC in the United Kingdom is high and comparable to published series in other countries from the 1990s. There may be a hidden mortality in patients who do not receive surgery.
Rees
Clare M
CM
Department of Paediatric Surgery, UCL Institute of Child Health and Great Ormond St Hospital, WC1N 1EH London, UK.
Eaton
Simon
S
Pierro
Agostino
A
D003430:Cross-Sectional Studies; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery / Q000628:therapy; D017052:Hospital Mortality; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D011159:Population Surveillance; D015995:Prevalence; D011446:Prospective Studies; D006113:United Kingdom / Q000453:epidemiology