Low serum albumin concentration predicts the need for surgical intervention in neonates with necrotizing enterocolitis

Sharif SP 1 , Friedmacher F 2 , Amin A 3 , Zaki RA 4 , Hird MF 5 , Khashu M 6 Show all authors , Phelps SR 3

Affiliations 

  • 1 Department of Paediatric Surgery, The Royal London Hospital, London, United Kingdom. Electronic address: shazia.sharif4@nhs.net
  • 2 Department of Paediatric Surgery, The Royal London Hospital, London, United Kingdom; Department of Pediatric Surgery, University Hospital Frankfurt, Frankfurt, Germany
  • 3 Department of Paediatric Surgery, The Royal London Hospital, London, United Kingdom
  • 4 Centre for Epidemiology & Evidence-Based Practice, Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 5 Department of Neonatal Medicine, The Royal London Hospital, London, United Kingdom
  • 6 Department of Neonatology, Poole Hospital NHS Foundation Trust, Poole, United Kingdom; Perinatal Health, Bournemouth University, Poole, Dorset, United Kingdom
J Pediatr Surg, 2020 Dec;55(12):2625-2629.
PMID: 32771214 DOI: 10.1016/j.jpedsurg.2020.07.003

Abstract

PURPOSE: To investigate whether serum albumin (SA) concentration can predict the need for surgical intervention in neonates with necrotizing enterocolitis (NEC).

METHODS: Retrospective review of all cases with NEC Bell's stage 2 and 3 that were treated in a single center between 2009 and 2015. Data on patient demographics, clinical parameters, laboratory findings and surgical status were recorded. Receiver operating characteristics analysis was used to evaluate optimal cutoffs and predictive values.

RESULTS: Overall, 151 neonates with NEC were identified. Of these, 132 (87.4%) had confirmed NEC Bell's stage 2. The median gestational age was 28.4 (range, 23.1-39.0) weeks and 69 (52.3%) had a birth weight of ≤1000 g. Sixty-eight (51.5%) underwent surgery, showing a sustained reduction in SA over time with significantly lower median SA levels compared to 64 (48.5%) cases that responded well to medical treatment (18.3 ± 3.7 g/L vs. 26.0 ± 2.0 g/L; P 

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