Outcomes following nec in the east of england. (7th June 2011)

• Record Type: Journal Article
• Authors: Mitra, S; Birch, J; Upton, M
• Is Part Of: Archives of disease in childhood. Volume 96(2011)Supplement 1
• Page Start: Fa26
• Page End: Fa26
• Publication Date: 2011-06-07
• Subjects: Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/archdischild.2011.300164.32
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : Background: A care bundle has been launched in the East of England to reduce the incidence of necrotising enterocolitis (NEC). As part of this initiative, we conducted a retrospective study of all NEC cases managed in the region in 2009. Aim: To evaluate the burden of NEC and its outcome in the East of England. Methods: A case of NEC was defined as 'an infant developing clinical features of NEC leading to commencement of antibiotics and stopping of feeds, both for a minimum of seven days'. Cases were identified from SEND and were cross-checked with individual unit databases. Data was collected from all 18 units in the region. Modified Bell's staging was used to characterise the infants. Results: 101 infants were treated for 112 episodes (incidence: 1.28/100 admissions). Total confirmed cases were 86 (incidence: 0.92%). 44% of cases were Bell's stage I, 20.3% cases stage II and 36.7% cases stage III. Mean gestation was 28 weeks 3 days (23 weeks 2 days–40 weeks 6 days), mean birth weight 1021 g (95% CI 989.5 to 1052.5). 53.7% cases were treated conservatively and 44.6% needed surgical intervention. 28 infants (25%) died, 2 before surgery. Highest mortality (72.7%) was noted in stage 3a. The incidence in level 3 units (1.8%) was significantly higher than level 2 and 1 units (1%). Availability of surgical facilities did not improve mortality in level 3 units. Conclusion: This region has a lower incidence of NEC compared to available national data but the mortality is high and needs strict surveillance.