Student Arkansas Children's Hospital Conway, Arkansas, United States
Background: Necrotizing Enterocolitis (NEC) is a neonatal intestinal illness associated with significant morbidity and mortality; however, disease presentation and severity of complications vary. Current research has centered on outcome differences and prognostication based on medical versus surgical NEC. The difference in disease presentation and outcomes based on the location of pneumatosis remains a significant knowledge gap. Objective: The overall objective of our study is to investigate the differences in clinical presentation and outcomes in neonates with colonic vs. small bowel pneumatosis. We hypothesize that neonates with colonic pneumatosis have a less severe clinical presentation and better outcomes than neonates with small bowel pneumatosis. Knowledge of differences in clinical presentation and adverse outcomes in colonic versus small bowel NEC could inform future studies re-evaluating our current practices of treating both entities with the same treatment regimes. Design/Methods: We performed a 7-year (2017-2023) retrospective cohort study of neonates with NEC at Arkansas Children’s Hospital. Demographic characteristics, perinatal events, clinical course, and outcomes were collected from the health record. The categorization of small bowel, colonic, or mixed NEC will be based on the radiologists’ reading of each X-ray. We have completed the chart review on 237 neonates. We await the radiologists' interpretation of the pneumatosis location on the X-rays. We expect this by January 2024. We will build a logistic regression model with a composite death or surgical intervention outcome. The primary independent variable is the location of NEC based on surgical pathology or X-ray when surgery was not performed. We will control for gestational age and birth weight.
