Necrotizing enterocolitis in the Perinatological Centre of the University Hospital Hradec Králové in 2010 - 2017
Abstract
Necrotizing enterocolitis (NEC) is a serious inflammatory disease affecting predominantly immature newborns. NEC ranges from moderate stages with mucosal intestine impairment to catastrophic illness with impairment of the entire alimentary canal including its perforation, development of peritonitis and shock.
Despite of care improvement NEC remains the leading cause of morbidity and mortality in premature newborns. Methods: Retrospective cohort analysis.
Results: During the years 2010-2017, 100 233 newborns were born in the region served by the Perinatological Centre of the University Hospital in Hradec Králové. This includes 7165 newborns with birth weight <2500 g, 907 newborns with birth weight <1500 g and 119 newborns with birth weight <750 g.
NEC classification (IIa and higher) according to the modified Bell's scale was diagnosed in total 86 cases, corresponding to 0.86%o incidence. NEC incidence was 5.6% in weight category <1500 g, 10.5% in weight category <1000 g and 12.6% in weight category <750 g.
Lethality of newborns was 53% in weigh category <750 g, 24.5% in weight category <1500 g and 23% in the entire group of NEC patients. Gestational age-related lethality was 33.3% for newborns born between 24th and 28th week of gestation, 22.7% for newborns born between 29th and 32nd week of gestation, and 10.7% for newborns born after 33rd week of gestation.
NEC stage II classification according to the modified Bell's scale was diagnosed 58 times in total, stage III was diagnosed 28 times in total. In total, 22 patients were treated conservatively and 64 patients underwent surgical treatment.
The overall lethality was 4.5% among the conservatively treated patients and 30% among the surgically treated patients. The average length of hospitalization was 49 days among the conservatively treated patients and 84 days among the surgically treated patients.
Conclusion: Our results are comparable to those published in other studies in Western Europe and North America. Although we can see slight decrease of the NEC incidence in our region during the last several years, necrotizing enterocolitis remains a very serious disease that fundamentally affects the survival and long-term outcome of premature newborns.