Changing trends in necrotizing enterocolitis: Experience with 302 cases in two decades

Jay L. Grosfeld, Henry Cheu, Marc Schlatter, Karen W. West, Frederick Rescorla

Research output: Contribution to journalArticle

101 Citations (Scopus)

Abstract

Three hundred two infants with necrotizing enterocolitis (NEC) were treated from 1972 to 1990. One hundred eighteen were treated medically while 184 infants required operation. Comparisons were made between two treatment periods, 1972 to 1982 (n = 176) and 1983 to 1990 (n = 126). Infants in the more recent era were of lower birth weight (1505 ± 853 g versus 1645 ± 836 g), earlier gestational age (30.4 ± 4.7 weeks versus 32.4.5 weeks; [p < 0.01]), had symptom onset at an older age (15.7 ± 13.9 days versus 10.0 ± 10.8 days; [p < 0.001]), and a lower incidence of hyaline membrane disease (p < 0.001). Fewer patients in the 1983 to 1990 group had acidosis (p < 0.001) and severe oliguria (p < 0.001). Operation was performed sooner after diagnosis in the second group (2.6 versus 3.8 days; [p < 0.001]). Survival was unaffected by sex, maternal complications, or whether infants were inborn or transferred from other facilities. Improved survival (1983 to 1990) was observed in those infants between 24 to 27 weeks gestation (p < 0.002) and those weighing less than 1000 g (p < 0.001). Since 1983 portal vein air (PVA) on abdominal radiographs was used as an indicator for operation. Survival in infants with PVA has improved from 29% to 64% (p < 0.02). Despite patients being more immature and weighing less, the overall survival rate improved from 58% (1972 to 1982) to 82% (1983 to 1990) (p < 0.001). Operative survival rate improved from 51% to 75% (p < 0.002). Long-term survival was 75% overall and 65% for surgical infants in the 1983 to 1990 group (p < 0.05).

Original languageEnglish
Pages (from-to)300-306
Number of pages7
JournalAnnals of Surgery
Volume214
Issue number3
StatePublished - Sep 1991

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Necrotizing Enterocolitis
Survival
Portal Vein
Survival Rate
Air
Hyaline Membrane Disease
Oliguria
Acidosis
Age of Onset
Birth Weight
Gestational Age
Mothers
Pregnancy
Incidence

ASJC Scopus subject areas

  • Surgery

Cite this

Grosfeld, J. L., Cheu, H., Schlatter, M., West, K. W., & Rescorla, F. (1991). Changing trends in necrotizing enterocolitis: Experience with 302 cases in two decades. Annals of Surgery, 214(3), 300-306.

Changing trends in necrotizing enterocolitis : Experience with 302 cases in two decades. / Grosfeld, Jay L.; Cheu, Henry; Schlatter, Marc; West, Karen W.; Rescorla, Frederick.

In: Annals of Surgery, Vol. 214, No. 3, 09.1991, p. 300-306.

Research output: Contribution to journalArticle

Grosfeld, JL, Cheu, H, Schlatter, M, West, KW & Rescorla, F 1991, 'Changing trends in necrotizing enterocolitis: Experience with 302 cases in two decades', Annals of Surgery, vol. 214, no. 3, pp. 300-306.
Grosfeld, Jay L. ; Cheu, Henry ; Schlatter, Marc ; West, Karen W. ; Rescorla, Frederick. / Changing trends in necrotizing enterocolitis : Experience with 302 cases in two decades. In: Annals of Surgery. 1991 ; Vol. 214, No. 3. pp. 300-306.
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