Nomogram for predicting fulminant necrotizing enterocolitis
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Read the article on pubmed.ncbi.nlm.nih.gov ↗Article · Jun 2023 · 1 min read
In brief
In brief
This study developed a validated nomogram to predict fulminant necrotizing enterocolitis (FNEC) in neonates using clinical parameters including ventilation status, shock, feeding volumes, and serial blood counts. The model demonstrated strong discrimination (AUC 0.884) and may enable earlier identification of high-risk patients for timely surgical intervention.
Written by the GCMD Library team from the article.
Background: Fulminant necrotizing enterocolitis (FNEC) is the most serious subtype of NEC and has a high mortality rate and a high incidence of sequelae. Onset prediction can help in the establishment of a customized treatment strategy. This study aimed to develop and evaluate a predictive nomogram for FNEC.
Methods: We conducted a retrospective observation to study the clinical data of neonates diagnosed with NEC (Bell stage ≥ IIB). Neonates were divided into the FNEC and NEC groups. A multivariate logistic regression model was used to construct the nomogram model. The performance of the nomogram was assessed using area under the curve, calibration analysis, and decision curve analysis.
Results: A total of 206 neonate cases were included, among which 40 (19.4%) fulfilled the definition of FNEC. The identified predictors were assisted ventilation after NEC onset; shock at NEC onset; feeding volumes before NEC onset; neutrophil counts on the day of NEC onset; and neutrophil, lymphocyte, and monocyte counts on day 1 after NEC onset. The nomogram exhibited good discrimination, with an area under the receiver operating characteristic curve of 0.884 (95% CI 0.825-0.943). The predictive model was well calibrated. Decision curve analysis confirmed the clinical usefulness of this nomogram.
Conclusion: A nomogram with a potentially effective application was developed to facilitate the individualized prediction of FNEC, with the hope of providing further direction for the early diagnosis of FNEC and timing of intervention.
DOI: 10.1007/s00383-023-05435-9