Journal of paediatrics and child health · 2026
Evaluation of a Clinical Risk Score for Preterm Necrotising Enterocolitis: The 'Check-NEC Score'.
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Davis Tiara, Rath Chandra, Athalye-Jape Gayatri, Nathan Elizabeth, Keelan Jeffrey, Patole Sanjay
Аннотация
BACKGROUND AND AIM: Early prediction of necrotising enterocolitis (NEC) in preterm infants is important given its significant health, economic and social-emotional burden. We aimed to validate a clinical risk score (Check-NEC Score [CNS]) for this purpose in preterm infants.
METHODS: A case-control study was conducted using data (January 2020-December 2023) from very preterm infants (VP: gestation < 32 weeks) with confirmed NEC≥Stage II. CNS was calculated for cases and controls (matched for key confounders) at baseline (T1), 7 days (T2), and 72 h (T3) before NEC diagnosis. Receiver operating characteristic (ROC) analysis was used to determine the sensitivity, specificity, and area under the curve (AUC).
RESULTS: Twenty-two cases of NEC≥Stage II diagnosed at a median (IQR) age of 17 (11-24) days were matched with 22 controls. Median CNS was significantly higher in cases compared to controls at T2 (8 vs. 7, p = 0.025) and T3 (8 vs. 7, p = 0.005). T3 CNS had the highest AUC (0.64, 95% CI 0.48-0.81). A cut-off score of ≥ 11 at T2 had the highest specificity (95%, 95% CI 75%-99%). At T3, a cut-off score of either ≥ 8 or ≥ 9 was best.
CONCLUSION: CNS demonstrated acceptable predictive ability at 72 h with high specificity 7 days before NEC diagnosis, depending on the cut-off score chosen.
METHODS: A case-control study was conducted using data (January 2020-December 2023) from very preterm infants (VP: gestation < 32 weeks) with confirmed NEC≥Stage II. CNS was calculated for cases and controls (matched for key confounders) at baseline (T1), 7 days (T2), and 72 h (T3) before NEC diagnosis. Receiver operating characteristic (ROC) analysis was used to determine the sensitivity, specificity, and area under the curve (AUC).
RESULTS: Twenty-two cases of NEC≥Stage II diagnosed at a median (IQR) age of 17 (11-24) days were matched with 22 controls. Median CNS was significantly higher in cases compared to controls at T2 (8 vs. 7, p = 0.025) and T3 (8 vs. 7, p = 0.005). T3 CNS had the highest AUC (0.64, 95% CI 0.48-0.81). A cut-off score of ≥ 11 at T2 had the highest specificity (95%, 95% CI 75%-99%). At T3, a cut-off score of either ≥ 8 or ≥ 9 was best.
CONCLUSION: CNS demonstrated acceptable predictive ability at 72 h with high specificity 7 days before NEC diagnosis, depending on the cut-off score chosen.