Chen Jin Yu, Yang Qian, Dai Li Rong, Wu Wei Yue, Zuo Wei, Wang Li Li
Department of pediatrics, the First Affiliated Hospital of Anhui Medical University, No. 218 Ji-Xi Road, Hefei, 230022, Anhui Province, P R China.
Ital J Pediatr. 2025 Aug 2;51(1):245. doi: 10.1186/s13052-025-02094-5.
Surgical intervention could improve the prognosis of infants with necrotizing enterocolitis (NEC), but it's also an independent risk factor for severe complications and death. This study aimed to establish a nomogram to predict the prognosis of infants with surgical NEC.
A total of 189 infants with surgical NEC were enrolled from January 2013 to May 2024. Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors. Then, a nomogram was constructed based on the risk factors.
This study demonstrated that gestational age, patent ductus arteriosus, mean corpuscular hemoglobin concentration and serum chlorine ion within 24 h before surgery, and pH within 24 h after surgery were independent risk factors to predict the prognosis of infants with surgical NEC. A nomogram was created utilizing the five predictors and showed excellent discriminative ability, with an area under the ROC curve of 0.842 [95% CI:0.772-0.912]. The concordance index for training and validation groups were 0.842 and 0.870, respectively.
The present study identified five independent predictors of poor prognosis in infants with surgical NEC and used them to establish a nomogram model, helping pediatricians identify poor prognosis in surgical NEC infants early and providing important clinical reference information.
手术干预可改善坏死性小肠结肠炎（NEC）婴儿的预后，但它也是严重并发症和死亡的独立危险因素。本研究旨在建立一个列线图来预测接受手术治疗的NEC婴儿的预后。
2013年1月至2024年5月共纳入189例接受手术治疗的NEC婴儿。进行单因素和多因素逻辑回归分析以确定独立危险因素。然后，根据危险因素构建列线图。
本研究表明，胎龄、动脉导管未闭、术前24小时内的平均红细胞血红蛋白浓度和血清氯离子以及术后24小时内的pH值是预测接受手术治疗的NEC婴儿预后的独立危险因素。利用这五个预测因素创建了一个列线图，其具有出色的判别能力，ROC曲线下面积为0.842 [95%CI：0.772 - 0.912]。训练组和验证组的一致性指数分别为0.842和0.870。
本研究确定了接受手术治疗的NEC婴儿预后不良的五个独立预测因素，并利用它们建立了列线图模型，有助于儿科医生早期识别手术NEC婴儿的不良预后，并提供重要的临床参考信息。
