Staging of necrotising enterocolitis by Bell's criteria is supported by a statistical pattern analysis of clinical and radiological variables

Sandra Meinich Juhl; Mathias Lühr Hansen; Magdalena Gormsen; Thomas Skov; Gorm Greisen

doi:10.1111/apa.14469

Staging of necrotising enterocolitis by Bell's criteria is supported by a statistical pattern analysis of clinical and radiological variables

Sandra Meinich Juhl^*, Mathias Lühr Hansen, Magdalena Gormsen, Thomas Skov, Gorm Greisen

^*Corresponding author for this work

3 Citations (Scopus)

Abstract

Aim: Necrotising enterocolitis (NEC) is often staged according to Bell's 1978 system, but today's NEC cases are more immature than the ones that were used to develop Bell's stages. Our aim was to explore the clinical and radiographic findings of contemporary cases of NEC and spontaneous intestinal perforation. Methods: We coded the clinical records of all cases of NEC stages I-III and spontaneous intestinal perforation born in 2006-2015 at the tertiary department of neonatology at Rigshospitalet, Denmark, for 16 clinical and radiographic symptoms and signs at disease onset and at climax. These variables were explored using principal component analysis, which can detect patterns in large datasets. Results: We reviewed 640 clinical records and included 158 cases of NEC or spontaneous intestinal perforation. When we entered the clinical and radiographic signs at disease climax, the cases were roughly grouped according to Bell's stages, except for a small group of NEC III cases, who were grouped with the cases of spontaneous intestinal perforation. Conclusion: An analysis of the pattern of clinical and radiographic findings in a 2006-2015 population of NEC cases supported Bell's 1978 staging system. However, the separation between NEC and spontaneous intestinal perforation still poses a difficult task.

Original language	English
Journal	Acta Paediatrica
Volume	108
Issue number	5
Pages (from-to)	842-848
ISSN	0803-5253
DOIs	https://doi.org/10.1111/apa.14469
Publication status	Published - May 2019

Keywords

Bells' staging system
Clinical presentation
Necrotising enterocolitis
Principal component analysis
Spontaneous intestinal perforation

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10.1111/apa.14469

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@article{e4159bd776e347ad856cd72014d9cc98,

title = "Staging of necrotising enterocolitis by Bell's criteria is supported by a statistical pattern analysis of clinical and radiological variables",

abstract = "Aim: Necrotising enterocolitis (NEC) is often staged according to Bell's 1978 system, but today's NEC cases are more immature than the ones that were used to develop Bell's stages. Our aim was to explore the clinical and radiographic findings of contemporary cases of NEC and spontaneous intestinal perforation. Methods: We coded the clinical records of all cases of NEC stages I-III and spontaneous intestinal perforation born in 2006-2015 at the tertiary department of neonatology at Rigshospitalet, Denmark, for 16 clinical and radiographic symptoms and signs at disease onset and at climax. These variables were explored using principal component analysis, which can detect patterns in large datasets. Results: We reviewed 640 clinical records and included 158 cases of NEC or spontaneous intestinal perforation. When we entered the clinical and radiographic signs at disease climax, the cases were roughly grouped according to Bell's stages, except for a small group of NEC III cases, who were grouped with the cases of spontaneous intestinal perforation. Conclusion: An analysis of the pattern of clinical and radiographic findings in a 2006-2015 population of NEC cases supported Bell's 1978 staging system. However, the separation between NEC and spontaneous intestinal perforation still poses a difficult task.",

keywords = "Bells' staging system, Clinical presentation, Necrotising enterocolitis, Principal component analysis, Spontaneous intestinal perforation",

author = "Juhl, {Sandra Meinich} and Hansen, {Mathias L{\"u}hr} and Magdalena Gormsen and Thomas Skov and Gorm Greisen",

year = "2019",

month = may,

doi = "10.1111/apa.14469",

language = "English",

volume = "108",

pages = "842--848",

journal = "Acta Paediatrica, International Journal of Paediatrics, Supplement",

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T1 - Staging of necrotising enterocolitis by Bell's criteria is supported by a statistical pattern analysis of clinical and radiological variables

AU - Juhl, Sandra Meinich

AU - Hansen, Mathias Lühr

AU - Gormsen, Magdalena

AU - Skov, Thomas

AU - Greisen, Gorm

PY - 2019/5

Y1 - 2019/5

N2 - Aim: Necrotising enterocolitis (NEC) is often staged according to Bell's 1978 system, but today's NEC cases are more immature than the ones that were used to develop Bell's stages. Our aim was to explore the clinical and radiographic findings of contemporary cases of NEC and spontaneous intestinal perforation. Methods: We coded the clinical records of all cases of NEC stages I-III and spontaneous intestinal perforation born in 2006-2015 at the tertiary department of neonatology at Rigshospitalet, Denmark, for 16 clinical and radiographic symptoms and signs at disease onset and at climax. These variables were explored using principal component analysis, which can detect patterns in large datasets. Results: We reviewed 640 clinical records and included 158 cases of NEC or spontaneous intestinal perforation. When we entered the clinical and radiographic signs at disease climax, the cases were roughly grouped according to Bell's stages, except for a small group of NEC III cases, who were grouped with the cases of spontaneous intestinal perforation. Conclusion: An analysis of the pattern of clinical and radiographic findings in a 2006-2015 population of NEC cases supported Bell's 1978 staging system. However, the separation between NEC and spontaneous intestinal perforation still poses a difficult task.

AB - Aim: Necrotising enterocolitis (NEC) is often staged according to Bell's 1978 system, but today's NEC cases are more immature than the ones that were used to develop Bell's stages. Our aim was to explore the clinical and radiographic findings of contemporary cases of NEC and spontaneous intestinal perforation. Methods: We coded the clinical records of all cases of NEC stages I-III and spontaneous intestinal perforation born in 2006-2015 at the tertiary department of neonatology at Rigshospitalet, Denmark, for 16 clinical and radiographic symptoms and signs at disease onset and at climax. These variables were explored using principal component analysis, which can detect patterns in large datasets. Results: We reviewed 640 clinical records and included 158 cases of NEC or spontaneous intestinal perforation. When we entered the clinical and radiographic signs at disease climax, the cases were roughly grouped according to Bell's stages, except for a small group of NEC III cases, who were grouped with the cases of spontaneous intestinal perforation. Conclusion: An analysis of the pattern of clinical and radiographic findings in a 2006-2015 population of NEC cases supported Bell's 1978 staging system. However, the separation between NEC and spontaneous intestinal perforation still poses a difficult task.

KW - Bells' staging system

KW - Clinical presentation

KW - Necrotising enterocolitis

KW - Principal component analysis

KW - Spontaneous intestinal perforation

U2 - 10.1111/apa.14469

DO - 10.1111/apa.14469

M3 - Journal article

C2 - 29926969

AN - SCOPUS:85050486084

SN - 0803-5253

VL - 108

SP - 842

EP - 848

JO - Acta Paediatrica, International Journal of Paediatrics, Supplement

JF - Acta Paediatrica, International Journal of Paediatrics, Supplement

IS - 5

ER -

Staging of necrotising enterocolitis by Bell's criteria is supported by a statistical pattern analysis of clinical and radiological variables

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Keywords

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