THE PROGNOSTIC VALUE OF A RISK SCORE FOR NECROTIZING ENTEROCOLITIS

Necrotising enterocolitis is the most common severe acquired gastroint estinal disorder in the neonate yet there remains disagreement on pred ictive and prognostic factors. A previously published risk score purpo rts to predict infants at greater risk of the disease. Fifty-nine case s and 59 matched controls were evaluated using data from the first 24 h after birth to determine the predictive and prognostic value of the score for necrotising enterocolitis. In simple models the risk score w as significantly, but inversely, associated with necrotising enterocol itis, primarily due to greater respiratory problems among controls. Th is finding contrary to the premise is clarified by a significant inter action of the risk score with feeding variables. Odds ratios for the r isk score varied at different levels of daily feeding increments. Howe ver, the risk score was not statistically significant in any models wh ich controlled for feeding increment and the interaction. The risk sco re was significantly associated with mortality among necrotising enter ocolitis cases. Though the score was not statistically significant whe n the outcome was disease stage or surgery, trends were in the expecte d direction. The data suggest that the risk score itself may not be an independent predictor of necrotising enterocolitis, but may indicate infants more vulnerable to other potential risk factors and, in additi on, may be related to prognosis for those who do develop necrotising e nterocolitis.