Skip to main content
main-content

01.03.2012 | Original Article | Ausgabe 3/2012

Pediatric Surgery International 3/2012

Could clinical scores guide the surgical treatment of necrotizing enterocolitis?

Zeitschrift:
Pediatric Surgery International > Ausgabe 3/2012
Autoren:
Vicente Ibáñez, Miguel Couselo, Verónica Marijuán, Juan José Vila, Carlos García-Sala

Abstract

Purpose

Test the diagnostic reliability of the score for neonatal acute physiology-perinatal extension-II (SNAPPE-II) and the metabolic derangement acuity score (MDAS) as predictors of surgery in patients with necrotizing enterocolitis (NEC).

Methods

The SNAPPE-II and the MDAS were applied to 99 patients with NEC. Both the scores were calculated at the moment of diagnosis (T0) and when surgical assessment was required (T1). The main outcome was the need of surgical revision. Comparison between models was made through their receiver operator characteristics (ROC) curves.

Results

Thirty-five patients required surgical treatment (group A) and 64 responded to medical therapy (group B). Median SNAPPE-II was 22 versus 5 for group A (U test 621, p = 0.002) at T0; and 22 versus 10 for group A (U test 487, p = 0.01) at T1. Measuring the value of the SNAPPE-II as a predictor of surgery, the ROC curve was 0.69 (CI 95%, 0.57–0.80) at T0 and 0.67 (CI 95%, 0.55–0.80) at T1. Median MDAS were 2 for both groups A and B at T0 (U test 890.5, p = 0.113) and 2 versus 1.5 for group A at T1 (U test 570, p = 0.043). The ROC curve for MDAS was 0.59 (CI 95%, 0.47–0.71) at T0 and 0.64 (CI 95%, 0.52–0.77) at T1.

Conclusions

The diagnostic performance of the SNAPPE-II offers mild results in the moment of the diagnosis of NEC, and at T1. The MDAS is non significant at T0 and obtains moderate results at T1. These results do not encourage using the SNAPPE-II and the MDAS as definite tools to decide for surgical treatment of the patients affected by NEC.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de.

Weitere Produktempfehlungen anzeigen
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 3/2012

Pediatric Surgery International 3/2012 Zur Ausgabe
  1. Sie können e.Med Chirurgie 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.

  2. Sie können e.Med Pädiatrie 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.

Neu im Fachgebiet Pädiatrie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Pädiatrie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise