Prognostic factors related to mortality in newborns with necrotising enterocolitis

BackgroundNecrotising enterocolitis is the most frequent and severe acquired gastrointestinal disease in newborns and still has high mortality. There are few published papers about prognostic factors of death in our country.ObjectiveTo know the factors associated with death in patients with necrotising enterocolitis.Material and methodsRetrospective, descriptive, comparative study with a case–control design was conducted on patients with necrotising enterocolitis during a 5-year period.ResultsDeceased patients had significantly lower platelet counts compared to survivors (p = 0.022) and the prognostic factors associated with mortality were anaemia (p = 0.006, OR = 15.62), stage III of necrotising enterocolitis (p < 0.001, OR = 47.5), to require surgical treatment (p < 0.001, OR = 47.5), to have intestinal necrosis (p = 0.001, OR = 48.5) or perforation (p = 0.016, OR = 24.25), to have medical complications, specifically intravascular disseminated coagulation (p < 0.001, RR = 98), and multi-organ failure (p < 0.001, RR = 2). It was also found that patients with gastrointestinal symptoms and diagnosis of necrotising enterocolitis when they were hospitalized were more likely to have surgical treatment.ConclusionsWe must be aware of the factors associated with mortality, as well as those associated with surgical treatment to reduce overall mortality for this condition.

ResumenAntecedentesLa enterocolitis necrosante es la patología digestiva adquirida más frecuente y grave en el período neonatal con alta mortalidad. Existen pocos estudios en nuestro medio sobre factores pronóstico de muerte.ObjetivoConocer los factores asociados a mortalidad en pacientes con enterocolitis necrosante.Material y métodosEstudio retrospectivo, comparativo, tipo casos y controles de neonatos con enterocolitis necrosante durante un periodo de 5 años.ResultadosLos pacientes fallecidos tuvieron significativamente menor cifra de plaquetas respecto a los sobrevivientes (p = 0.022), los factores asociados con significancia estadística a mortalidad fueron anaemia (p = 0.006, OR = 15.62), estadio III de la enfermedad (p = <0.001, OR = 47.5), requerir tratamiento quirúrgico (p = <0.001, OR = 47.5), tener necrosis (p = 0.001, OR = 48.5) o perforación intestinal (p = 0.016, OR = 24.25), padecer complicaciones médicas especialmente coagulación intravascular diseminada (p = <0.001, OR = 98) y falla orgánica múltiple (p = <0.001, RR = 2). Además se encontró que los pacientes con síntomas gastrointestinales y diagnóstico de enterocolitis necrosante al ingreso tuvieron asociación con tratamiento quirúrgico.ConclusionesSe debe estar atento a los factores asociados a mortalidad; así como, los que se asocian a tratamiento quirúrgico, para en conjunto disminuir la tasa de mortalidad en esta entidad.