Evidence map›Paper›PMID 41286688›Full record

ArticleBMC pediatrics2025

Analysis of risk factors and establishment of a predictive model for brain injury in neonates with surgical necrotizing enterocolitis: a retrospective study.

Xinyin Zhang, Huan Wei, Qi Tan, Zhengli Wang, Hanbin Zhao, Zhenhua Guo, Wei Liu, Jian Cao

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PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Xinyin ZhangDepartment of Neonatology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Structural Birth Defect and Reconstruction, Chongqing, China.
Huan WeiDepartment of Neonatology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Structural Birth Defect and Reconstruction, Chongqing, China.
Qi TanDepartment of Neonatology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Structural Birth Defect and Reconstruction, Chongqing, China.
Zhengli WangDepartment of Neonatology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Structural Birth Defect and Reconstruction, Chongqing, China.
Hanbin ZhaoDepartment of General & Neonatal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, China.
Zhenhua GuoDepartment of General & Neonatal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, China.
Wei LiuDepartment of General & Neonatal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, China.
Jian CaoDepartment of General & Neonatal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing, China. 405273993@qq.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeonatal necrotizing enterocolitis (NEC) is prevalent among preterm neonates and is associated with high morbidity and mortality. While surgical intervention remains essential for advanced NEC, postoperative neonates exhibit an elevated risk of brain injury. However, which surgery-related factors exacerbate neonatal brain damage remains insufficiently investigated. This study aimed to identify risk factors for brain injury in neonates with surgical NEC and establish a predictive model to facilitate early identification and intervention, which may ultimately decrease neurodevelopmental impairment rates.

methodsThis study analyzed 181 consecutive NEC surgical cases at our tertiary referral center (2017-2023). Brain injury was confirmed by cranial MRI. Primary analysis was used to compare groups via Student's t test for normally distributed data and the Mann‒Whitney U/χ

resultsMultivariate analysis revealed six independent risk factors (all p < 0.05): lower gestational age (GA) (OR 0.85 [95% CI: 0.73-0.98]; p = 0.028), higher procalcitonin (PCT) levels at surgery (OR 1.03 [95% CI: 1.01-1.06]; p = 0.017), postoperative sepsis (OR 3.46 [95% CI: 1.36-8.76]; p = 0.009), transmural necrosis with perforation (OR 3.03 [95% CI: 1.18-7.78]; p = 0.021), longer diagnosis-to-surgery intervals (> 24 h) (OR 3.52 [95% CI: 1.23-10.08]; p = 0.019), and retention of the necrotic bowel (OR 4.88 [95% CI: 1.50-15.91]; p = 0.009). The ROC analysis revealed an area under the curve (AUC) of 0.86 for the prediction model.

conclusionThe incidence of brain injury in neonates with surgical NEC is independently associated with elevated PCT levels at surgery, the presence of sepsis, and the occurrence of transmural necrosis with perforation. Conversely, increased GA, early surgical recognition and intervention, and complete resection of the necrotic bowel may serve as potential protective factors against brain injury. The predictive model constructed on the basis of these findings demonstrated strong discriminative ability and we propose immediate neuroprotective intervention when model-predicted risk exceeds the 53% threshold.

Indexed as

Brain InjuriesEnterocolitis, NecrotizingPostoperative ComplicationsFemaleGestational AgeHumansInfant, NewbornInfant, PrematureMagnetic Resonance ImagingMaleProcalcitoninRetrospective StudiesRisk FactorsROC CurveProcalcitoninBrain injuryNecrotizing enterocolitisNeonatal surgeryPredictive modelRisk factors

Identifiers

PMID41286688
PMCPMC12642268

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.