A predictive model for prognosis in infants with surgical necrotizing enterocolitis.

Background: Surgical intervention could improve the prognosis of infants with necrotizing enterocolitis (NEC), but it's also an independent risk factor for severe complications and death. This study aimed to establish a nomogram to predict the prognosis of infants with surgical NEC.

Methods: A total of 189 infants with surgical NEC were enrolled from January 2013 to May 2024. Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors. Then, a nomogram was constructed based on the risk factors.

Results: This study demonstrated that gestational age, patent ductus arteriosus, mean corpuscular hemoglobin concentration and serum chlorine ion within 24 h before surgery, and pH within 24 h after surgery were independent risk factors to predict the prognosis of infants with surgical NEC. A nomogram was created utilizing the five predictors and showed excellent discriminative ability, with an area under the ROC curve of 0.842 [95% CI:0.772-0.912]. The concordance index for training and validation groups were 0.842 and 0.870, respectively.

Conclusions: The present study identified five independent predictors of poor prognosis in infants with surgical NEC and used them to establish a nomogram model, helping pediatricians identify poor prognosis in surgical NEC infants early and providing important clinical reference information.