title: Advanced necrotizing enterocolitis part 1: mortality.
abstract: OBJECTIVE
  The aim of this study was to investigate the factors associated with mortality in infants referred for the surgical treatment of advanced necrotizing enterocolitis (NEC).
  
  
  METHODS
  Retrospective review of all infants with confirmed (Bell stage II or III) NEC treated in our unit during the past 8 years (January 2002 to December 2010). Data for survivors and nonsurvivors were compared using Mann-Whitney test and Fisher's exact test and are reported as median (range).
  
  
  RESULTS
  Of the 205 infants with NEC, 35 (17%) were medically managed; 170 (83%) had surgery; 66 (32%) infants died; all had received surgery. Survivors and nonsurvivors were comparable for gestational age, birth weight, and gender distribution. Overall mortality was 32%, the highest mortality was in infants with pan-intestinal disease (86%) but remained significant in those with less severe disease (multifocal 39%; focal disease 21%). The commonest cause of mortality was multiple organ dysfunction syndrome and nearly half of the nonsurvivors had care withdrawn.
  
  
  CONCLUSIONS
  Despite improvement in neonatal care, overall mortality (32%) for advanced NEC has not changed in 10 years. Mortality is significant even with minimal bowel involvement.
authors.affiliation: Department of Surgery, Great Ormond Street Hospital and UCL Institute of Child Health, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Thyoka
authors.forename: P
authors.initials: P
authors.lastname: de Coppi
authors.forename: S
authors.initials: S
authors.lastname: Eaton
authors.forename: K
authors.initials: K
authors.lastname: Khoo
authors.forename: N J
authors.initials: NJ
authors.lastname: Hall
authors.forename: J
authors.initials: J
authors.lastname: Curry
authors.forename: E
authors.initials: E
authors.lastname: Kiely
authors.forename: D
authors.initials: D
authors.lastname: Drake
authors.forename: K
authors.initials: K
authors.lastname: Cross
authors.forename: A
authors.initials: A
authors.lastname: Pierro
mesh_terms: D015984:Causality; D002423:Cause of Death; D020345:Enterocolitis, Necrotizing / Q000401:mortality* / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009102:Multiple Organ Failure / Q000401:mortality*; D012044:Regression Analysis; D012189:Retrospective Studies; D015996:Survival Rate