A simple presurgical necrotizing enterocolitis-mortality scoring system

J Perinatol. 2006 Dec;26(12):764-8. doi: 10.1038/sj.jp.7211613.


Objective: To assess the relationship between early laboratory parameters, disease severity, type of management (surgical or conservative) and outcome in necrotizing enterocolitis (NEC).

Study design: Retrospective collection and analysis of data from infants treated in a single tertiary care center (1980 to 2002). Data were collected on disease severity (Bell stage), birth weight (BW), gestational age (GA) and pre-intervention laboratory parameters (leukocyte and platelet counts, hemoglobin, lactate, C-reactive protein).

Results: Data from 128 infants were sufficient for analysis. Factors significantly associated with survival were Bell stage (P<0.05), lactate (P<0.05), BW and GA (P<0.01, P<0.001, respectively). From receiver operating characteristics curves, the highest predictive value resulted from a score with 0 to 8 points combining BW, Bell stage, lactate and platelet count (P<0.001). At a cutoff level of 4.5 sensitivity and specificity for predicting survival were 0.71 and 0.72, respectively.

Conclusion: Some single parameters were associated with poor outcome in NEC. Optimal risk stratification was achieved by combining several parameters in a score.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Birth Weight*
  • Enterocolitis, Necrotizing / blood
  • Enterocolitis, Necrotizing / classification*
  • Enterocolitis, Necrotizing / mortality
  • Enterocolitis, Necrotizing / therapy
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / classification
  • Infant, Premature, Diseases / mortality
  • Infant, Premature, Diseases / therapy
  • Lactic Acid / blood*
  • Male
  • ROC Curve
  • Retrospective Studies
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Survival Analysis


  • Lactic Acid