A prospective evaluation of the risk factors and utility of GutCheckNEC scoring system to predict necrotizing enterocolitis in preterm newborns, in a tertiary care centre in North India

Abstract

Background: Necrotizing enterocolitis (NEC) is a serious gastrointestinal disease of neonate with high fatality. GutCheckNEC scoring system can be used in predicting NEC and decrease NEC rate. Aims: To assess risk factors and use scoring system GutCheckNEC in predicting necrotising enterocolitis. Methods: A prospective observational study with preterms, birth weight <1500grams was done. Risk factor assessment was done using GutCheckNEC and serial scorings were done. Descriptive analyses of the various risk factors assessed were done. Results: 51 babies included, with gestational age 24 to 35 weeks (Median (IQR) 30+2 (27+2, 31+6), birth weight 500 to 1500 grams (Median (IQR) – 1105 (893, 1300). 9 NEC cases, 6(11.5%) confirmed NEC and 2(22%) were surgical NEC. Absence of ANS, HsPDA and late onset sepsis were risk factors. The median (IQR) scoring at 72 hrs., 86 hrs., 7 days, 14days, 21days and 28 days were 34 (31, 38), 34 (30, 39), 34 (26, 43), 31 (23, 35), 35 (23, 38), 35 (30, 40). The median risk for developing NEC was high (33-36) on all days except day 14, when it was moderate (20-32). The sensitivity and specificity for a cut off >32 at 86hours was 85.7% and 48.5% (PPV – 26.1%, NPV – 94%) for medical NEC and 100% and 44.7% (PPV – 8.7%, NPV – 100%) respectively for surgical NEC. Conclusion: Hence we conclude that GUTCHECK can help in early prediction of NEC and prevention of NEC.