Abdominal ultrasound findings contribute to a multivariable predictive risk score for surgical necrotizing enterocolitis: A pilot study
| Autor: | David Zurakowski, Steven J. Staffa, Richard B. Parad, Stefanie P. Lazow, Ilse Castro-Aragon, Judy A. Estroff, Sarah A. Tracy, Catherine Chen, Alan M. Fujii |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Erythema Abdominal ultrasound Pilot Projects Logistic regression Risk Assessment Infant Newborn Diseases Abdominal wall 03 medical and health sciences 0302 clinical medicine Enterocolitis Necrotizing Risk Factors 030225 pediatrics Abdomen Humans Medicine 030212 general & internal medicine Retrospective Studies Ultrasonography Framingham Risk Score business.industry Abdominal Wall Infant Newborn General Medicine medicine.disease digestive system diseases Surgery Radiography Logistic Models medicine.anatomical_structure Area Under Curve Necrotizing enterocolitis Female Physical exam medicine.symptom business Bowel wall |
| Zdroj: | The American Journal of Surgery. 222:1034-1039 |
| ISSN: | 0002-9610 |
| DOI: | 10.1016/j.amjsurg.2021.04.025 |
| Popis: | Background Abdominal ultrasound (AUS) is a promising adjunct to abdominal x-ray (AXR) for evaluating necrotizing enterocolitis (NEC). We developed a multivariable risk score incorporating AUS to predict surgical NEC. Methods 83 patients were evaluated by AXR and AUS for suspected NEC. A subset had surgical NEC. Multivariate logistic regression determined predictors of surgical NEC, which were incorporated into a risk score. Results 14/83 patients (16.9%) had surgical NEC. 10/83 (12.0%) patients required acute intervention, while 4/83 (4.8%) patients only required delayed surgery. Four predictors of surgical NEC were identified: abdominal wall erythema (OR: 8.2, p = 0.048), portal venous gas on AXR (OR: 29.8, p = 0.014), and echogenic free fluid (OR: 17.2, p = 0.027) and bowel wall thickening (OR: 12.5, p = 0.030) on AUS. A multivariable risk score incorporating these predictors had excellent area-under-the-curve of 0.937 (95% CI: 0.879–0.994). Conclusions AUS, as an adjunct to physical exam and AXR, has utility for predicting surgical NEC. |
| Databáze: | OpenAIRE |
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