Radiological findings associated with the death of newborns with necrotizing enterocolitis

Detalhes bibliográficos
Autor(a) principal: Santos,Isabela Gusson Galdino dos
Data de Publicação: 2018
Outros Autores: Mezzacappa,Maria Aparecida, Alvares,Beatriz Regina
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Radiologia Brasileira (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-39842018000300166
Resumo: Abstract Objective: The aim of this study was to identify radiological and clinical risk factors for death in newborns with necrotizing enterocolitis. Materials and Methods: This was a retrospective cohort study, based on radiological examinations and medical charts of 66 infants with necrotizing enterocolitis, as confirmed by a finding of intestinal pneumatosis (stage IIA, according to modified Bell’s staging criteria). Radiological and clinical variables were evaluated. Results: Of the 66 infants evaluated, 14 (21.2%) presented pneumatosis in the large and small bowel; 7 (10.6%) presented air in the portal system; and 12 (18.2%) died. Bivariate analysis revealed that the following variables were associated with death: bowel perforation; pneumatosis in the large and small bowel; air in the portal system; earlier gestational age; longer time on mechanical ventilation before the identification of pneumatosis; and longer time on mechanical ventilation before discharge or death. In the multivariate regression, the following variables remained as predictors of death: pneumatosis in the large and small intestines (odds ratio [OR] = 12.4; 95% confidence interval [95% CI] = 1.2-127.4; p = 0.035), perforation (OR = 23.2; 95% CI = 2.2-246.7; p = 0.009), and air in the portal system (OR = 69.7; 95% CI = 4.3-[not calculated]; p = 0.003). Conclusion: The set of factors most strongly associated with death in infants with necrotizing enterocolitis comprised extensive pneumatosis, pneumoperitoneum, and air in the portal system. Our findings confirm the importance of radiological imaging in the diagnosis and monitoring of necrotizing enterocolitis.
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spelling Radiological findings associated with the death of newborns with necrotizing enterocolitisEnterocolitis, necrotizing/diagnosisInfant, prematurePremature birthPerinatal deathAbstract Objective: The aim of this study was to identify radiological and clinical risk factors for death in newborns with necrotizing enterocolitis. Materials and Methods: This was a retrospective cohort study, based on radiological examinations and medical charts of 66 infants with necrotizing enterocolitis, as confirmed by a finding of intestinal pneumatosis (stage IIA, according to modified Bell’s staging criteria). Radiological and clinical variables were evaluated. Results: Of the 66 infants evaluated, 14 (21.2%) presented pneumatosis in the large and small bowel; 7 (10.6%) presented air in the portal system; and 12 (18.2%) died. Bivariate analysis revealed that the following variables were associated with death: bowel perforation; pneumatosis in the large and small bowel; air in the portal system; earlier gestational age; longer time on mechanical ventilation before the identification of pneumatosis; and longer time on mechanical ventilation before discharge or death. In the multivariate regression, the following variables remained as predictors of death: pneumatosis in the large and small intestines (odds ratio [OR] = 12.4; 95% confidence interval [95% CI] = 1.2-127.4; p = 0.035), perforation (OR = 23.2; 95% CI = 2.2-246.7; p = 0.009), and air in the portal system (OR = 69.7; 95% CI = 4.3-[not calculated]; p = 0.003). Conclusion: The set of factors most strongly associated with death in infants with necrotizing enterocolitis comprised extensive pneumatosis, pneumoperitoneum, and air in the portal system. Our findings confirm the importance of radiological imaging in the diagnosis and monitoring of necrotizing enterocolitis.Publicação do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem2018-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-39842018000300166Radiologia Brasileira v.51 n.3 2018reponame:Radiologia Brasileira (Online)instname:Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR)instacron:CBR10.1590/0100-3984.2017.0040info:eu-repo/semantics/openAccessSantos,Isabela Gusson Galdino dosMezzacappa,Maria AparecidaAlvares,Beatriz Reginaeng2018-07-10T00:00:00Zoai:scielo:S0100-39842018000300166Revistahttps://www.scielo.br/j/rb/https://old.scielo.br/oai/scielo-oai.phpradiologiabrasileira@cbr.org.br1678-70990100-3984opendoar:2018-07-10T00:00Radiologia Brasileira (Online) - Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR)false
dc.title.none.fl_str_mv Radiological findings associated with the death of newborns with necrotizing enterocolitis
title Radiological findings associated with the death of newborns with necrotizing enterocolitis
spellingShingle Radiological findings associated with the death of newborns with necrotizing enterocolitis
Santos,Isabela Gusson Galdino dos
Enterocolitis, necrotizing/diagnosis
Infant, premature
Premature birth
Perinatal death
title_short Radiological findings associated with the death of newborns with necrotizing enterocolitis
title_full Radiological findings associated with the death of newborns with necrotizing enterocolitis
title_fullStr Radiological findings associated with the death of newborns with necrotizing enterocolitis
title_full_unstemmed Radiological findings associated with the death of newborns with necrotizing enterocolitis
title_sort Radiological findings associated with the death of newborns with necrotizing enterocolitis
author Santos,Isabela Gusson Galdino dos
author_facet Santos,Isabela Gusson Galdino dos
Mezzacappa,Maria Aparecida
Alvares,Beatriz Regina
author_role author
author2 Mezzacappa,Maria Aparecida
Alvares,Beatriz Regina
author2_role author
author
dc.contributor.author.fl_str_mv Santos,Isabela Gusson Galdino dos
Mezzacappa,Maria Aparecida
Alvares,Beatriz Regina
dc.subject.por.fl_str_mv Enterocolitis, necrotizing/diagnosis
Infant, premature
Premature birth
Perinatal death
topic Enterocolitis, necrotizing/diagnosis
Infant, premature
Premature birth
Perinatal death
description Abstract Objective: The aim of this study was to identify radiological and clinical risk factors for death in newborns with necrotizing enterocolitis. Materials and Methods: This was a retrospective cohort study, based on radiological examinations and medical charts of 66 infants with necrotizing enterocolitis, as confirmed by a finding of intestinal pneumatosis (stage IIA, according to modified Bell’s staging criteria). Radiological and clinical variables were evaluated. Results: Of the 66 infants evaluated, 14 (21.2%) presented pneumatosis in the large and small bowel; 7 (10.6%) presented air in the portal system; and 12 (18.2%) died. Bivariate analysis revealed that the following variables were associated with death: bowel perforation; pneumatosis in the large and small bowel; air in the portal system; earlier gestational age; longer time on mechanical ventilation before the identification of pneumatosis; and longer time on mechanical ventilation before discharge or death. In the multivariate regression, the following variables remained as predictors of death: pneumatosis in the large and small intestines (odds ratio [OR] = 12.4; 95% confidence interval [95% CI] = 1.2-127.4; p = 0.035), perforation (OR = 23.2; 95% CI = 2.2-246.7; p = 0.009), and air in the portal system (OR = 69.7; 95% CI = 4.3-[not calculated]; p = 0.003). Conclusion: The set of factors most strongly associated with death in infants with necrotizing enterocolitis comprised extensive pneumatosis, pneumoperitoneum, and air in the portal system. Our findings confirm the importance of radiological imaging in the diagnosis and monitoring of necrotizing enterocolitis.
publishDate 2018
dc.date.none.fl_str_mv 2018-06-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-39842018000300166
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-39842018000300166
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/0100-3984.2017.0040
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Publicação do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem
publisher.none.fl_str_mv Publicação do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem
dc.source.none.fl_str_mv Radiologia Brasileira v.51 n.3 2018
reponame:Radiologia Brasileira (Online)
instname:Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR)
instacron:CBR
instname_str Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR)
instacron_str CBR
institution CBR
reponame_str Radiologia Brasileira (Online)
collection Radiologia Brasileira (Online)
repository.name.fl_str_mv Radiologia Brasileira (Online) - Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR)
repository.mail.fl_str_mv radiologiabrasileira@cbr.org.br
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