Necrotizing enterocolitis: improving survival within a single facility

• Published in: Southern medical journal (Birmingham, Ala.) Vol. 82; no. 9; p. 1103
• Main Authors: Black, T L, Carr, M G, Korones, S B
• Format: Journal Article
• Language: English
• Published: United States 01.09.1989
• Subjects: Acute Disease; Birth Weight; Combined Modality Therapy; Emergencies; Enterocolitis, Pseudomembranous - epidemiology; Enterocolitis, Pseudomembranous - mortality; Enterocolitis, Pseudomembranous - surgery; Enterocolitis, Pseudomembranous - therapy; Evaluation Studies as Topic; Hospitals, District; Humans; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature, Diseases - epidemiology; Infant, Premature, Diseases - mortality; Infant, Premature, Diseases - surgery; Infant, Premature, Diseases - therapy; Intensive Care Units, Neonatal; Retrospective Studies; Tennessee; Tennessee
• ISSN: 0038-4348
• DOI: 10.1097/00007611-198909000-00011

Necrotizing enterocolitis (NEC), a disease associated with prematurity, carries a significant morbidity and mortality. This study was designed to evaluate our progress in dealing with NEC both medically and surgically in a single large neonatal intensive care unit (NICU). We also sought to confirm the relation of birth weight and particular indications for operation to outcome. Over 6 1/2 years, there were 7,807 admissions to a large NICU. Though there has been a steady increase in total admissions, especially of infants weighing less than 1,000 gm, survival has improved significantly in all groups (mean 89.1%). NEC occurred in 358 infants (4.6%), and 115 (32%) required surgical intervention. Infants weighing between 751 and 1,000 gm had the highest incidence of NEC. There has been a significant decrease in the mortality of both medically and surgically treated infants with NEC; in both cases, this decrease is weight-dependent. We found that using erythema and edema of the abdominal wall and a fixed-loop roentgenographic pattern as early indicators of necrotic bowel significantly improves survival in surgically treated infants.