Staging of necrotising enterocolitis by Bell's criteria is supported by a statistical pattern analysis of clinical and radiological variables
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Staging of necrotising enterocolitis by Bell's criteria is supported by a statistical pattern analysis of clinical and radiological variables. / Juhl, Sandra Meinich; Hansen, Mathias Lühr; Gormsen, Magdalena; Skov, Thomas; Greisen, Gorm.
In: Acta Paediatrica, Vol. 108, No. 5, 2019, p. 842-848.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - Staging of necrotising enterocolitis by Bell's criteria is supported by a statistical pattern analysis of clinical and radiological variables
AU - Juhl, Sandra Meinich
AU - Hansen, Mathias Lühr
AU - Gormsen, Magdalena
AU - Skov, Thomas
AU - Greisen, Gorm
PY - 2019
Y1 - 2019
N2 - Aim: Necrotising enterocolitis (NEC) is often staged according to Bell's 1978 system, but today's NEC cases are more immature than the ones that were used to develop Bell's stages. Our aim was to explore the clinical and radiographic findings of contemporary cases of NEC and spontaneous intestinal perforation. Methods: We coded the clinical records of all cases of NEC stages I-III and spontaneous intestinal perforation born in 2006-2015 at the tertiary department of neonatology at Rigshospitalet, Denmark, for 16 clinical and radiographic symptoms and signs at disease onset and at climax. These variables were explored using principal component analysis, which can detect patterns in large datasets. Results: We reviewed 640 clinical records and included 158 cases of NEC or spontaneous intestinal perforation. When we entered the clinical and radiographic signs at disease climax, the cases were roughly grouped according to Bell's stages, except for a small group of NEC III cases, who were grouped with the cases of spontaneous intestinal perforation. Conclusion: An analysis of the pattern of clinical and radiographic findings in a 2006-2015 population of NEC cases supported Bell's 1978 staging system. However, the separation between NEC and spontaneous intestinal perforation still poses a difficult task.
AB - Aim: Necrotising enterocolitis (NEC) is often staged according to Bell's 1978 system, but today's NEC cases are more immature than the ones that were used to develop Bell's stages. Our aim was to explore the clinical and radiographic findings of contemporary cases of NEC and spontaneous intestinal perforation. Methods: We coded the clinical records of all cases of NEC stages I-III and spontaneous intestinal perforation born in 2006-2015 at the tertiary department of neonatology at Rigshospitalet, Denmark, for 16 clinical and radiographic symptoms and signs at disease onset and at climax. These variables were explored using principal component analysis, which can detect patterns in large datasets. Results: We reviewed 640 clinical records and included 158 cases of NEC or spontaneous intestinal perforation. When we entered the clinical and radiographic signs at disease climax, the cases were roughly grouped according to Bell's stages, except for a small group of NEC III cases, who were grouped with the cases of spontaneous intestinal perforation. Conclusion: An analysis of the pattern of clinical and radiographic findings in a 2006-2015 population of NEC cases supported Bell's 1978 staging system. However, the separation between NEC and spontaneous intestinal perforation still poses a difficult task.
KW - Bells' staging system
KW - Clinical presentation
KW - Necrotising enterocolitis
KW - Principal component analysis
KW - Spontaneous intestinal perforation
U2 - 10.1111/apa.14469
DO - 10.1111/apa.14469
M3 - Journal article
C2 - 29926969
AN - SCOPUS:85050486084
VL - 108
SP - 842
EP - 848
JO - Acta Paediatrica
JF - Acta Paediatrica
SN - 0803-5253
IS - 5
ER -
ID: 210055356