Mohd Amin, Amir T. and Zaki, Rafdzah A. and Friedmacher, Florian and Sharif, Shazia P. (2021) C-reactive protein/albumin ratio is a prognostic indicator for predicting surgical intervention and mortality in neonates with necrotizing enterocolitis. Pediatric Surgery International, 37 (7). pp. 881-886. ISSN 0179-0358, DOI https://doi.org/10.1007/s00383-021-04879-1.
Full text not available from this repository.Abstract
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.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | Necrotizing enterocolitis; C-reactive protein; Albumin; Surgery; Mortality; Outcomes |
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 03 Mar 2022 01:42 |
| Last Modified: | 03 Mar 2022 01:42 |
| URI: | http://eprints.um.edu.my/id/eprint/26437 |
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