Fardou H Heida1, Lisanne Stolwijk2, Marie-Louise H J Loos2, Stannie J van den Ende2, Wes Onland3, Frank A M van den Dungen4, Elisabeth M W Kooi5, Arend F Bos5, Jan B F Hulscher6, Roel Bakx2. 1. Department of Pediatric Surgery, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, The Netherlands. Electronic address: f.h.heida@umcg.nl. 2. Department of Pediatric Surgery, Pediatric Surgical Center Amsterdam, Amsterdam, The Netherlands. 3. Department of Neonatology Academic Medical Center, Amsterdam, The Netherlands. 4. Department of Neonatology, VU University Medical Center, Amsterdam, The Netherlands. 5. Department of Neonatology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, The Netherlands. 6. Department of Pediatric Surgery, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, The Netherlands.
Abstract
INTRODUCTION: Necrotizing enterocolitis (NEC) is a severe inflammatory disease, mostly occurring in preterm infants. The Dutch guidelines for active treatment of extremely preterm infants changed in 2006 from 26+0 to 25+0weeks of gestation, and in 2010 to 24+0 of gestation. We aimed to gain insight into the incidence, clinical outcomes and treatment strategies, in three academic referral centers in the Netherlands over the last nine years. METHODS: We performed a multicenter retrospective cohort study of all patients with NEC (Bell stage ≥2a) in three academic referral centers diagnosed between 2005 and 2013. Outcome measures consisted of incidence, changes in clinical presentation, treatment strategies and mortality. RESULTS: Between 2005 and 2013 14,161 children were admitted to the neonatal intensive care unit in the three centers. The overall percentage of children born at a gestational age of 24weeks and 25weeks increased with 1.7% after the introduction of the guidelines in 2006 and 2010. The incidence of NEC increased significantly (period 2005-2007: 2.1%; period 2008-2010 3.9%; period 2011-2013: 3.4%; P=0.001). We observed a significant decrease of peritoneal drainages (↓16%; P=0.001) and a decrease of laparotomies (↓24%; P=0.002). The mortality rate (33% in 2011-2013) remained unchanged. CONCLUSION: The incidence of NEC significantly increased in the last nine years. The increase in incidence of NEC seemed to be related to an increase in infants born at a gestational age of 24 and 25weeks. The percentage of patients needing surgery decreased, while 30-day mortality did not change. LEVEL OF EVIDENCE: Level IV.
INTRODUCTION:Necrotizing enterocolitis (NEC) is a severe inflammatory disease, mostly occurring in preterm infants. The Dutch guidelines for active treatment of extremely preterm infants changed in 2006 from 26+0 to 25+0weeks of gestation, and in 2010 to 24+0 of gestation. We aimed to gain insight into the incidence, clinical outcomes and treatment strategies, in three academic referral centers in the Netherlands over the last nine years. METHODS: We performed a multicenter retrospective cohort study of all patients with NEC (Bell stage ≥2a) in three academic referral centers diagnosed between 2005 and 2013. Outcome measures consisted of incidence, changes in clinical presentation, treatment strategies and mortality. RESULTS: Between 2005 and 2013 14,161 children were admitted to the neonatal intensive care unit in the three centers. The overall percentage of children born at a gestational age of 24weeks and 25weeks increased with 1.7% after the introduction of the guidelines in 2006 and 2010. The incidence of NEC increased significantly (period 2005-2007: 2.1%; period 2008-2010 3.9%; period 2011-2013: 3.4%; P=0.001). We observed a significant decrease of peritoneal drainages (↓16%; P=0.001) and a decrease of laparotomies (↓24%; P=0.002). The mortality rate (33% in 2011-2013) remained unchanged. CONCLUSION: The incidence of NEC significantly increased in the last nine years. The increase in incidence of NEC seemed to be related to an increase in infants born at a gestational age of 24 and 25weeks. The percentage of patients needing surgery decreased, while 30-day mortality did not change. LEVEL OF EVIDENCE: Level IV.
Authors: Ilse H de Lange; Charlotte van Gorp; Laurens D Eeftinck Schattenkerk; Wim G van Gemert; Joep P M Derikx; Tim G A M Wolfs Journal: Nutrients Date: 2021-05-19 Impact factor: 5.717
Authors: Carlos Zozaya; Inés García González; Alejandro Avila-Alvarez; Niki Oikonomopoulou; Tomás Sánchez Tamayo; Enrique Salguero; Miguel Saenz de Pipaón; Fermín García-Muñoz Rodrigo; María L Couce Journal: Front Pediatr Date: 2020-05-13 Impact factor: 3.418
Authors: Isabelle M C Ree; Anne M de Grauw; Vincent Bekker; Masja de Haas; Arjan B Te Pas; Dick Oepkes; Annemieke J M Middeldorp; Enrico Lopriore Journal: Vox Sang Date: 2019-12-19 Impact factor: 2.144
Authors: Annebel Ten Broeke; Jan Hulscher; Nicolaas Heyning; Elisabeth Kooi; Caspar Chorus Journal: Med Decis Making Date: 2021-03-30 Impact factor: 2.583