{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T04:23:48Z","timestamp":1788236628689,"version":"build-2803163510"},"reference-count":37,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:00:00Z","timestamp":1742515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Necrotizing enterocolitis (NEC) is a leading cause of death in very preterm born infants. The most severe variant is NEC totalis (NEC-T), where necrosis of the small intestines is so extensive that curative care is often withdrawn. Mortality and NEC-T are difficult to predict before surgery, complicating counseling and decision-making. This study's aim was to identify preoperative risk factors for overall 30-day mortality and NEC-T in preterm born infants with surgical NEC.<\/jats:p><jats:p>This multicenter retrospective cohort study included preterm born infants (&lt;35 weeks) surgically treated for NEC between 2008 and 2022. NEC-T was defined as necrosis of the majority of small intestine, leading to a surgical open-close procedure without curative treatment. Preoperative risk factors for 30-day postoperative mortality, NEC-T, and mortality without NEC-T were assessed using multivariable logistic regression analyses.<\/jats:p><jats:p>Among the 401 patients included, the 30-day mortality rate was 34.2% (137\/401), of which 18.7% (75\/401) involved NEC-T. Significant risk factors for mortality were male sex (odds ratio [OR]: 2.53; 95% confidence interval [CI]: 1.54\u20134.16), lower birthweight (OR: 0.91; 95% CI: 0.86\u20130.96\/100\u2009g), portal venous gas (PVG) on abdominal radiograph (OR: 1.89; 95% CI: 1.11\u20133.20), need for cardiovascular support between NEC diagnosis and surgery (OR: 3.26; 95% CI: 2.02\u20135.24), and shorter time between diagnosis and surgery (OR: 0.74; 95% CI: 0.65\u20130.84). Similar risk factors were found for NEC-T. In patients without NEC-T, the need for cardiovascular support (OR: 2.33; 95% CI: 1.33\u20134.09) and time between diagnosis and surgery (OR: 0.77; 95% CI: 0.64\u20130.91) were significant.<\/jats:p><jats:p>Male sex, lower birthweight, PVG, cardiovascular support, and a short interval between NEC diagnosis and surgery are preoperative risk factors for 30-day mortality and NEC-T. Preoperative cardiovascular support and a shorter time interval between diagnosis and surgery are also risk factors for mortality without NEC-T.<\/jats:p><jats:p>II<\/jats:p>","DOI":"10.1055\/a-2536-4757","type":"journal-article","created":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T20:47:01Z","timestamp":1742590021000},"page":"332-340","source":"Crossref","is-referenced-by-count":5,"title":["Risk Factors for 30-day Mortality in Patients with Surgically Treated Necrotizing Enterocolitis: A Multicenter Retrospective Cohort Study"],"prefix":"10.1055","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4086-7050","authenticated-orcid":false,"given":"Adinda G.H.","family":"Pijpers","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"},{"name":"Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Amsterdam Reproduction and Development Research Institute, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ceren","family":"Imren","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, Sophia Children's Hospital, Erasmus MC, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8764-7744","authenticated-orcid":false,"given":"Otis C.","family":"van Varsseveld","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Pediatric Surgery, Beatrix Children's Hospital, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurens D. Eeftinck","family":"Schattenkerk","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"},{"name":"Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Amsterdam Reproduction and Development Research Institute, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia M.G.","family":"Keyzer-Dekker","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Sophia Children's Hospital, Erasmus MC, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan B.F.","family":"Hulscher","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Pediatric Surgery, Beatrix Children's Hospital, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth M.W.","family":"Kooi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5494-730X","authenticated-orcid":false,"given":"Chris H.P.","family":"van den Akker","sequence":"additional","affiliation":[{"name":"Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Amsterdam Reproduction and Development Research Institute, University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Department of Pediatrics, Neonatology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost","family":"van Schuppen","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Rob","family":"Taal","sequence":"additional","affiliation":[{"name":"Department of Neonatal and Paediatric Intensive Care, Division of Neonatology, Erasmus University Medical Center, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos W.R.","family":"Twisk","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joep P.M.","family":"Derikx","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"},{"name":"Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Amsterdam Reproduction and Development Research Institute, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marijn J.","family":"Vermeulen","sequence":"additional","affiliation":[{"name":"Department of Neonatal and Paediatric Intensive Care, Division of Neonatology, Erasmus University Medical Center, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,3,21]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1186\/s12887-020-02231-5","article-title":"Global incidence of necrotizing enterocolitis: a systematic review and meta-analysis","volume":"20","author":"A Alsaied","year":"2020","journal-title":"BMC Pediatr"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.jpeds.2019.11.011","article-title":"Contemporary outcomes for infants with necrotizing enterocolitis-a systematic review","volume":"220","author":"I H Jones","year":"2020","journal-title":"J 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