Maes, G. (Gwendolyn) (2012) The use of clinical parameters in prediction of progression of necrotizing enterocolitis to need for surgery in neonates: Clear cut-off or not? thesis, Medicine.
Full text available on request.Abstract
In this retrospective study we studied the predictive values for the progression of necrotizing enterocolitis (NEC) in the need for surgery (laparotomy) and mortality of demographics, clinical characteristics and different laboratory values. Laboratory values of C-reactive protein (CRP), glucose, lactate, platelets, leukocytes and pH were collected for initial diagnose (baseline) and 12, 24, 36, 48, 60 and 72 hours after initial diagnosis. Our hypothesis was that these variables can be used as predictors for the progression and outcomes of NEC. In a cohort of 192 infants -of which 44 died and 84 needed surgery- CRP, platelet levels and pH levels were predictive for the need for surgery and/or the outcome of mortality. Lactate and leukocyte levels were significantly lower in the group with more severe NEC, compared to the group without surgery and/or mortality. Receiver Operating Characteristic curve analysis showed that 12 hours after initial diagnosis CRP levels of 60 mg/L or higher and platelet levels of 130,5x109/L or lower gave a 3.83 and 2.97 times higher chance on surgery and/or mortality, respectively. At 24 hours after initial diagnosis, CRP levels of 68, 5 mg/L or higher, platelet levels of 137,5x109/L or lower and pH levels of 7.33 or lower gave a 6.92, 3.22 and 4.33 times higher chance on surgery and/or mortality, respectively. Based upon this study we can conclude that infants with NEC were more likely to need surgery or have the outcome of mortality when they had higher levels of CRP, lower platelet and lower pH levels. Although these laboratory values reflect general illness, they can be valuable for the decision making in the treatment and the prediction of NEC.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisor: and Hulscher, Dr. J.B.F. and Department: Surgery and University Medical Centre Groningen |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:44 |
| Last Modified: | 25 Jun 2020 10:44 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/575 |
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