Low serum albumin concentration predicts the need for surgical intervention in neonates with necrotizing enterocolitis

Authors: Sharif, S.P., Friedmacher, F., Amin, A., Zaki, R.A., Hird, M.F., Khashu, M. and Phelps, S.R.

Journal: Journal of Pediatric Surgery

Volume: 55

Issue: 12

Pages: 2625-2629

eISSN: 1531-5037

ISSN: 0022-3468

DOI: 10.1016/j.jpedsurg.2020.07.003

Abstract:

Purpose: To investigate whether serum albumin (SA) concentration can predict the need for surgical intervention in neonates with necrotizing enterocolitis (NEC). Methods: Retrospective review of all cases with NEC Bell's stage 2 and 3 that were treated in a single center between 2009 and 2015. Data on patient demographics, clinical parameters, laboratory findings and surgical status were recorded. Receiver operating characteristics analysis was used to evaluate optimal cutoffs and predictive values. Results: Overall, 151 neonates with NEC were identified. Of these, 132 (87.4%) had confirmed NEC Bell's stage 2. The median gestational age was 28.4 (range, 23.1–39.0) weeks and 69 (52.3%) had a birth weight of ≤ 1000 g. Sixty-eight (51.5%) underwent surgery, showing a sustained reduction in SA over time with significantly lower median SA levels compared to 64 (48.5%) cases that responded well to medical treatment (18.3 ± 3.7 g/L vs. 26.0 ± 2.0 g/L; P < 0.001). SA concentration of ≤ 20 g/L on day 2 of NEC diagnosis was a significant predictor for surgery (OR 3.41; P = 0.019) with a positive predictive value of 71.4%. Conclusions: An SA concentration of ≤ 20 g/L on day 2 of the NEC disease process is associated with a higher likelihood for surgical intervention in neonates with NEC Bell's stage 2. SA, in combination with other clinical parameters and serological markers, may be a useful predictive tool for surgery in NEC. Level of evidence: II

Source: Scopus

Low serum albumin concentration predicts the need for surgical intervention in neonates with necrotizing enterocolitis.

Authors: Sharif, S.P., Friedmacher, F., Amin, A., Zaki, R.A., Hird, M.F., Khashu, M. and Phelps, S.R.

Journal: J Pediatr Surg

Volume: 55

Issue: 12

Pages: 2625-2629

eISSN: 1531-5037

DOI: 10.1016/j.jpedsurg.2020.07.003

Abstract:

PURPOSE: To investigate whether serum albumin (SA) concentration can predict the need for surgical intervention in neonates with necrotizing enterocolitis (NEC). METHODS: Retrospective review of all cases with NEC Bell's stage 2 and 3 that were treated in a single center between 2009 and 2015. Data on patient demographics, clinical parameters, laboratory findings and surgical status were recorded. Receiver operating characteristics analysis was used to evaluate optimal cutoffs and predictive values. RESULTS: Overall, 151 neonates with NEC were identified. Of these, 132 (87.4%) had confirmed NEC Bell's stage 2. The median gestational age was 28.4 (range, 23.1-39.0) weeks and 69 (52.3%) had a birth weight of ≤1000 g. Sixty-eight (51.5%) underwent surgery, showing a sustained reduction in SA over time with significantly lower median SA levels compared to 64 (48.5%) cases that responded well to medical treatment (18.3 ± 3.7 g/L vs. 26.0 ± 2.0 g/L; P < 0.001). SA concentration of ≤20 g/L on day 2 of NEC diagnosis was a significant predictor for surgery (OR 3.41; P = 0.019) with a positive predictive value of 71.4%. CONCLUSIONS: An SA concentration of ≤20 g/L on day 2 of the NEC disease process is associated with a higher likelihood for surgical intervention in neonates with NEC Bell's stage 2. SA, in combination with other clinical parameters and serological markers, may be a useful predictive tool for surgery in NEC. LEVEL OF EVIDENCE: II.

Source: PubMed

Low serum albumin concentration predicts the need for surgical intervention in neonates with necrotizing enterocolitis

Authors: Sharif, S.P., Friedmacher, F., Amin, A., Zaki, R.A., Hird, M.F., Khashu, M. and Phelps, S.R.

Journal: JOURNAL OF PEDIATRIC SURGERY

Volume: 55

Issue: 12

Pages: 2625-2629

eISSN: 1531-5037

ISSN: 0022-3468

DOI: 10.1016/j.jpedsurg.2020.07.003

Source: Web of Science (Lite)

Low serum albumin concentration predicts the need for surgical intervention in neonates with necrotizing enterocolitis.

Authors: Sharif, S.P., Friedmacher, F., Amin, A., Zaki, R.A., Hird, M.F., Khashu, M. and Phelps, S.R.

Journal: Journal of pediatric surgery

Volume: 55

Issue: 12

Pages: 2625-2629

eISSN: 1531-5037

ISSN: 0022-3468

DOI: 10.1016/j.jpedsurg.2020.07.003

Abstract:

Purpose

To investigate whether serum albumin (SA) concentration can predict the need for surgical intervention in neonates with necrotizing enterocolitis (NEC).

Methods

Retrospective review of all cases with NEC Bell's stage 2 and 3 that were treated in a single center between 2009 and 2015. Data on patient demographics, clinical parameters, laboratory findings and surgical status were recorded. Receiver operating characteristics analysis was used to evaluate optimal cutoffs and predictive values.

Results

Overall, 151 neonates with NEC were identified. Of these, 132 (87.4%) had confirmed NEC Bell's stage 2. The median gestational age was 28.4 (range, 23.1-39.0) weeks and 69 (52.3%) had a birth weight of ≤1000 g. Sixty-eight (51.5%) underwent surgery, showing a sustained reduction in SA over time with significantly lower median SA levels compared to 64 (48.5%) cases that responded well to medical treatment (18.3 ± 3.7 g/L vs. 26.0 ± 2.0 g/L; P < 0.001). SA concentration of ≤20 g/L on day 2 of NEC diagnosis was a significant predictor for surgery (OR 3.41; P = 0.019) with a positive predictive value of 71.4%.

Conclusions

An SA concentration of ≤20 g/L on day 2 of the NEC disease process is associated with a higher likelihood for surgical intervention in neonates with NEC Bell's stage 2. SA, in combination with other clinical parameters and serological markers, may be a useful predictive tool for surgery in NEC.

Level of evidence

II.

Source: Europe PubMed Central