Pediatric surgery international · 2026
Coagulation and fibrinolysis markers at birth as early predictors of surgical necrotizing enterocolitis in extremely low-birth-weight infants.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Yano Keisuke, Harumatsu Toshio, Sugita Koshiro, Yara Asataro, Tabata Yumiko, Ogata Masato, Murakami Masakazu, Kawano Masato, Masuya Ryuta, Matsukubo Makoto, Kawano Takafumi, Muto Mitsuru, Machigashira Seiro, Torikai Motofumi, Ibara Satoshi, Tokuhisa Takuya, Ieiri Satoshi
Аннотация
PURPOSE: Early identification of surgical necrotizing enterocolitis (S-NEC) before clinical deterioration remains challenging in extremely low-birth-weight infants (ELBWIs). We evaluated whether coagulation and fibrinolysis markers at birth could predict subsequent S-NEC.
METHODS: We retrospectively analyzed 250 ELBWIs (< 1000 g) treated from 2013 to 2022; 22 developed S-NEC. Eleven coagulation and fibrinolysis markers were measured within 24 h of birth. Multivariable logistic regression models and a simple birth-time risk score were developed.
RESULTS: Relative to controls, S-NEC infants had higher D-dimer (11.7 vs. 5.5 µg/mL, p = 0.003) and PT-INR (1.71 vs. 1.42, p = 0.023), prolonged PT (62.2 vs. 52.7 s, p = 0.022), and lower fibrinogen (107.3 vs. 160.7 mg/dL, p = 0.037). Multivariable models showed stepwise improvement in discrimination (AUC 0.668, 0.710, 0.763). A four-item risk score (D-dimer > 5 µg/mL, PT-INR > 1.5, fibrinogen < 100 mg/dL, and birth weight < 700 g) achieved an AUC of 0.702, with 85.0% sensitivity and 96.3% negative predictive value (NPV). S-NEC incidence increased across risk categories (3.7%, 14.5%, and 19.6%; p for trend = 0.013).
CONCLUSIONS: Hemostatic abnormalities at birth were associated with subsequent S-NEC in ELBWIs, suggesting perinatal or intrauterine origins. The risk score showed a high NPV and may serve as a practical rule-out tool for early neonatal intensive care unit stratification.
METHODS: We retrospectively analyzed 250 ELBWIs (< 1000 g) treated from 2013 to 2022; 22 developed S-NEC. Eleven coagulation and fibrinolysis markers were measured within 24 h of birth. Multivariable logistic regression models and a simple birth-time risk score were developed.
RESULTS: Relative to controls, S-NEC infants had higher D-dimer (11.7 vs. 5.5 µg/mL, p = 0.003) and PT-INR (1.71 vs. 1.42, p = 0.023), prolonged PT (62.2 vs. 52.7 s, p = 0.022), and lower fibrinogen (107.3 vs. 160.7 mg/dL, p = 0.037). Multivariable models showed stepwise improvement in discrimination (AUC 0.668, 0.710, 0.763). A four-item risk score (D-dimer > 5 µg/mL, PT-INR > 1.5, fibrinogen < 100 mg/dL, and birth weight < 700 g) achieved an AUC of 0.702, with 85.0% sensitivity and 96.3% negative predictive value (NPV). S-NEC incidence increased across risk categories (3.7%, 14.5%, and 19.6%; p for trend = 0.013).
CONCLUSIONS: Hemostatic abnormalities at birth were associated with subsequent S-NEC in ELBWIs, suggesting perinatal or intrauterine origins. The risk score showed a high NPV and may serve as a practical rule-out tool for early neonatal intensive care unit stratification.