A predictive model for prognosis in infants with surgical necrotizing enterocolitis

Abstract

Background

Surgical intervention could improve the prognosis of infants with necrotizing enterocolitis (NEC), but it’s also an independent risk factor for severe complications and death. This study aimed to establish a nomogram to predict the prognosis of infants with surgical NEC.

Methods

A total of 189 infants with surgical NEC were enrolled from January 2013 to May 2024. Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors. Then, a nomogram was constructed based on the risk factors.

Results

This study demonstrated that gestational age, patent ductus arteriosus, mean corpuscular hemoglobin concentration and serum chlorine ion within 24 h before surgery, and pH within 24 h after surgery were independent risk factors to predict the prognosis of infants with surgical NEC. A nomogram was created utilizing the five predictors and showed excellent discriminative ability, with an area under the ROC curve of 0.842 [95% CI:0.772–0.912]. The concordance index for training and validation groups were 0.842 and 0.870, respectively.

Conclusions

The present study identified five independent predictors of poor prognosis in infants with surgical NEC and used them to establish a nomogram model, helping pediatricians identify poor prognosis in surgical NEC infants early and providing important clinical reference information.