Evrard et al developed a score for identifying infants with necrotizing enterocolitis (NEC) who are at an increased risk for developing intestinal stricture. The authors are from the University of Liege in Belgium.
Parameters, as determined on the 8th day after onset of the enterocolitis:
(1) general status
(2) ileus
(3) abdominal wall
(4) C-reactive protein
(5) extent of pneumatosis intestinalis
(6) duration of pneumatosis intestinalis
|
Parameter |
Finding |
Points |
|
general status |
no sign of shock |
0 |
|
|
signs of shock |
1 |
|
|
need for artificial ventilation |
2 |
|
ileus |
< 24 hours |
0 |
|
|
>= 24 hours |
1 |
|
abdominal wall |
no erythema of the abdominal wall |
0 |
|
|
erythema of the abdominal wall |
1 |
|
C-reactive protein (CRP) |
<= 0.5 mg/dL |
0 |
|
|
> 0.5 mg/dL for < 7 days |
1 |
|
|
> 0.5 mg/dL for >= 7 days |
2 |
|
extent of pneumatosis |
limited to a single intestinal segment |
1 |
|
|
more than 1 segment |
2 |
|
duration of pneumatosis |
< 24 hours |
1 |
|
|
>= 24 hours |
2 |
from Table 2, page 758
where:
• I added an entry for CRP <= 0.5 mg/dL; this was not in the original table
• The duration of ileus and pneumatosis were < 24 and > 24 hours. I added the >= 24 hours. Similarly, CRP was listed as < 7 and > 7 days.
• I did not add an entry for no pneumatosis since that was a defining feature for NEC.
score on day 8 after onset of necrotizing enterocolitis =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 2
• maximum score: 10
• A score of >= 7 determined on day 8 indicates an infant at greater risk of developing intestinal stricture. These infants should have closer followup for early detection of the strictures.
Specialty: Gastroenterology, Pedatrics
ICD-10: ,
