Document Detail

Could clinical scores guide the surgical treatment of necrotizing enterocolitis?
MedLine Citation:
PMID:  22002167     Owner:  NLM     Status:  Publisher    
PURPOSE: Test the diagnostic reliability of the score for neonatal acute physiology-perinatal extension-II (SNAPPE-II) and the metabolic derangement acuity score (MDAS) as predictors of surgery in patients with necrotizing enterocolitis (NEC). METHODS: The SNAPPE-II and the MDAS were applied to 99 patients with NEC. Both the scores were calculated at the moment of diagnosis (T(0)) and when surgical assessment was required (T(1)). The main outcome was the need of surgical revision. Comparison between models was made through their receiver operator characteristics (ROC) curves. RESULTS: Thirty-five patients required surgical treatment (group A) and 64 responded to medical therapy (group B). Median SNAPPE-II was 22 versus 5 for group A (U test 621, p = 0.002) at T(0); and 22 versus 10 for group A (U test 487, p = 0.01) at T(1). Measuring the value of the SNAPPE-II as a predictor of surgery, the ROC curve was 0.69 (CI 95%, 0.57-0.80) at T(0) and 0.67 (CI 95%, 0.55-0.80) at T(1). Median MDAS were 2 for both groups A and B at T(0) (U test 890.5, p = 0.113) and 2 versus 1.5 for group A at T(1) (U test 570, p = 0.043). The ROC curve for MDAS was 0.59 (CI 95%, 0.47-0.71) at T(0) and 0.64 (CI 95%, 0.52-0.77) at T(1). CONCLUSIONS: The diagnostic performance of the SNAPPE-II offers mild results in the moment of the diagnosis of NEC, and at T(1). The MDAS is non significant at T(0) and obtains moderate results at T(1). These results do not encourage using the SNAPPE-II and the MDAS as definite tools to decide for surgical treatment of the patients affected by NEC.
Vicente Ibáñez; Miguel Couselo; Verónica Marijuán; Juan José Vila; Carlos García-Sala
Related Documents :
23490297 - Selective external endarterectomy in patients with ipsilateral symptomatic internal car...
20634777 - Role of intravitreal bevacizumab (avastin) injected at the end of diabetic vitrectomy i...
16198777 - Ocular pemphigus.
24312317 - The effect of a maturing antiretroviral program on early mortality for patients with ad...
22796637 - A retrospective analysis of the impact of azithromycin maintenance therapy on adults at...
11907307 - A randomized clinical trial to compare three methods of orthodontic space closure.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-15
Journal Detail:
Title:  Pediatric surgery international     Volume:  -     ISSN:  1437-9813     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8609169     Medline TA:  Pediatr Surg Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Hospital Infantil La Fe, Valencia, Spain.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Viral subversion of the host protein synthesis machinery.
Next Document:  Brain steroid contents in the catfish Heteropneustes fossilis: sex and gonad stage-specific changes.