Risk Factors Of Intestinal Failure From Necrotizinf Enterocolitis Underwent Surgery

Objective: The present study was sought to investigate the risk factors associated with the incidence of intestinal failure(IF)in infants who received operative treatment for neonatal necrotizing enterocolitis(NEC).Methods: A sample of 91 Neonates enrolled in Children's Hospital of Chongqing Medical University between January 2010 and December 2017 who diagnosed with NEC and underwent surgical treatment were conducted in a retrospective case-series study.Depending on whether achieved full enteral feeding(FEF),two groups were divided,named IF group and FEF group.A contrastive analysis to the maternal history,clinical data,surgical information and postoperative complications between the two groups was made.Then univariate and logistic regression analysis were employed to find the pedictors of IF.Results: Of 91 infants admitted in this study,NEC diagnostic age was6-26 days after birth,with an average of 10 days,the surgical age was amedian time period of 13 days(range:7-45),and 32(35.2%)cases developed IF.The univariate analysis showed that gestational week,birth weight,postpartum intubation,postpartum PS usage,ventilator assistance,albumin level,age at diagnosis of NEC,postnatal age at operation,length of bowel reseced,length of small bowel resected,percentage of small bowel resected,and resection of ileocecal valve were significantly different between the two groups(p<0.05).Then variables with significant difference in univariate analysis p<0.01 were included in stepwise forward logistic regression analysis identified that the length of bowel receted(OR=1.109,95%CI: 1.048 to 1.173,p<0.001),and the percentage of small bowel resected(OR=1.305,95%CI: 1.133 to 1.504,p<0.001)were the independent risk factors of IF from necrotizing enterocolitis underwent surgery,birth weight(OR=0.999,95%CI: 0.998 to 1.000,p=0.010)was a protective factor.Conclusion: Our data demonstrates that the greater extent of bowel resection and the larger percentage of small bowel resection were,the higher risk of IF occured for those NEC infants recieved operative treatment was.Moreover,birth weight was a protective factor for IF.