Risk factors for concurrent sepsis in neonates with necrotizing enterocolitis
AN Yao, LIU Li, LI Qiu-Yu, RAN Ya-Lin, LI Lu-Quan
Neonatal Diagnosis and Treatment Center, Children's Hospital of Chongqing Medical University/National Demonstration Base of Standardized Training Base for Resident Physicians/Ministry of Education Key Laboratory of Child Development and Disorders/Key Laboratory of Pediatrics in Chongqing/Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing 400014, China
Abstract Objective To investigate the risk factors for concurrent sepsis in neonates with necrotizing enterocolitis (NEC). Methods A retrospective analysis was performed for the clinical data of 273 neonates with NEC. The risk factors for concurrent sepsis were analyzed from the aspects of perinatal factors and treatment regimen before the diagnosis of NEC. Results The incidence rate of concurrent sepsis in NEC was 32.2% (88/273). The neonates with stage Ⅲ NEC had a significantly higher incidence rate of concurrent sepsis than those with stage Ⅱ NEC (69.0% vs 15.9%; P < 0.05). Of all neonates with sepsis, 62.5% experienced sepsis within 3 days after the diagnosis of NEC, and 37.5% experienced sepsis more than 3 days after the diagnosis. Compared with those without concurrent sepsis, the neonates with concurrent sepsis had significantly lower gestational age and birth weight (P < 0.05). The neonates who had scleredema, had stage Ⅲ NEC, needed gastrointestinal decompression after the diagnosis of NEC, and experienced a long time of gastrointestinal decompression tended to develop sepsis more easily (P < 0.05). Scleredema (OR=9.75, 95%CI:2.84-33.52, P < 0.001), stage Ⅲ NEC (OR=12.94, 95%CI:6.82-24.55, P < 0.001), and gastrointestinal decompression (OR=2.27, 95%CI:1.14-4.5, P=0.02) were independent risk factors for concurrent sepsis in NEC. Conclusions Scleredema, stage Ⅲ NEC, and gastrointestinal decompression are independent risk factors for concurrent sepsis in neonates with NEC.
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