Risk factors associated with postnecrotizing enterocolitis strictures in infants

F. H. Heida*, M. H. J. Loos, L. Stolwijk, B. J. C. Te Kiefte, S. J. van den Ende, W. Onland, R. R. van Rijn, R. Dikkers, F. A. M. van den Dungen, E. M. W. Kooi, A. F. Bos, J. B. F. Hulscher, R. Bakx

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

13 Citaten (Scopus)


Introduction: Survivors of necrotizing enterocolitis (NEC) often develop a post-NEC intestinal stricture, causing severe and prolonged morbidity. Objectives: We first aimed to determine the incidence of post-NEC strictures. Second, we aimed to determine risk factors associated with intestinal post-NEC strictures.

Materials and Methods: A total of 441 patients diagnosed with NEC Bell's stage >= 2 were retrospectively included in three academic pediatric surgical centers between January 2005 and January 2013. Clinical data were related to the occurrence of intestinal post-NEC strictures. Post-NEC strictures were defined as clinically relevant strictures with a radiological and/or surgical confirmation of this post-NEC stricture.

Results: The median gestational age of the 337 survivors of the acute phase of NEC was 29 weeks (range 24-41) and median birth weight was 1130 g (range 410-4130). Of the survivors, 37 (17%) medically treated NEC patients developed a post-NEC strictures versus 27 surgically treated NEC patients (24%; p = 0.001). Highest Creactive protein (CRP) level measured during the NEC episode was associated with the development of post-NEC strictures (OR 1.20, 95% confidence interval 1.11-1.32; p = 0.03). No post-NEC strictures were detected in patients with CRP levels

Conclusion: This multicenter retrospective cohort study demonstrates an overall incidence of clinical relevant post-NEC strictures of 19%, with a higher rate (24%) in NEC cases treated surgically. Increased CRP levels during the NEC episode were associated with the development of post-NEC strictures. (C) 2016 Elsevier Inc. All rights reserved.

Originele taal-2English
Pagina's (van-tot)1126-1130
Aantal pagina's5
TijdschriftJournal of Pediatric Surgery
Nummer van het tijdschrift7
StatusPublished - jul-2016

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