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C-reactive protein/albumin ratio is a prognostic indicator for predicting surgical intervention and mortality in neonates with necrotizing enterocolitis
- Purpose: The role of hypoalbuminemia and raised C-reactive protein (CRP) levels in predicting critical prognosis has been described extensively in adult literature. However, there are limited studies in pediatrics, particularly neonates. The CRP/albumin (CRP/ALB) ratio is often associated with higher mortality, organ failure and prolonged hospital stay. We hypothesized that the serum CRP/ALB ratio has a prognostic value in predicting surgery and mortality in neonates with necrotizing enterocolitis (NEC). Methods: Retrospective review of all neonates with clinical and radiological evidence of non-perforated NEC that were treated in a tertiary-level referral hospital between 2009 and 2018. General patient demographics, laboratory parameters and outcomes were recorded. Receiver operating characteristics analysis was performed to evaluated optimal cut-offs and area under the curve (AUC) with 95% confidence intervals (CI). Results: A total of 191 neonates were identified. Of these, 103 (53.9%) were born at ≤ 28 weeks of gestation and 101 (52.9%) had a birth weight of ≤ 1000 g. Eighty-four (44.0%) patients underwent surgical intervention for NEC. The overall survival rate was 161/191 (84.3%). A CRP/ALB ratio of ≥ 3 on day 2 of NEC diagnosis was associated with a statistically significant higher likelihood for surgery [AUC 0.71 (95% CI 0.63–0.79); p < 0.0001] and mortality [AUC 0.66 (95% CI 0.54–0.77); p = 0.0150], respectively. Conclusions : A CRP/ALB ratio of ≥ 3 on day 2 is indicative of a critical pathway in neonates with radiologically confirmed, non-perforated NEC. This could be used as an additional criterion to guide parental counselling in NEC for surgical intervention and mortality.
Author: | Amir T. Mohd Amin, Rafdzah A. Zaki, Florian Michael FriedmacherORCiDGND, Shazia P. Sharif |
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URN: | urn:nbn:de:hebis:30:3-808128 |
DOI: | https://doi.org/10.1007/s00383-021-04879-1 |
ISSN: | 1437-9813 |
Parent Title (English): | Pediatric Surgery International |
Publisher: | Springer |
Place of publication: | Berlin ; Heidelberg |
Document Type: | Article |
Language: | English |
Date of Publication (online): | 2021/03/29 |
Date of first Publication: | 2021/03/29 |
Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
Release Date: | 2024/03/20 |
Tag: | Albumin; C-reactive protein; Mortality; Necrotizing enterocolitis; Outcomes; Surgery |
Volume: | 37 |
Issue: | 7 |
Page Number: | 6 |
First Page: | 881 |
Last Page: | 886 |
Note: | Open Access funding enabled and organized by Projekt DEAL. |
HeBIS-PPN: | 521024005 |
Institutes: | Medizin |
Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Sammlungen: | Universitätspublikationen |
Licence (German): | Creative Commons - CC BY - Namensnennung 4.0 International |