What is the prognosis of necrotizing enterocolitis (NEC)?

Updated: Dec 27, 2017
  • Author: Shelley C Springer, JD, MD, MSc, MBA, FAAP; Chief Editor: Muhammad Aslam, MD  more...
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With improved supportive intensive care, including ventilatory management, anesthetic techniques, and total parenteral nutrition, the survival of infants with necrotizing enterocolitis (NEC) has steadily improved since the late 20th century. The improved prognosis is most notable in critically ill neonates younger than 28 weeks' gestational age who weigh less than 1000 g. However, these neonates are still at significantly increased risk for pan involvement and are more likely than other premature infants to require surgery.

The mortality rate in NEC ranges from 10% to more than 50% in infants who weigh less than 1500 g, depending on the severity of disease, compared with a mortality rate of 0-20% in babies who weigh more than 2500 g. Extremely premature infants (1000 g) are still particularly vulnerable, with reported mortality rates of 40-100%. One study comparing mortality rates for term versus preterm infants reported rates of 4.7% for term infants and 11.9% for premature babies. [26]

The improvement in treatment efficacy in infants with NEC is underscored by the fact that if patients with pan involvement are excluded, the survival in surgically treated infants with NEC is 95%. However, comparison between reported series is difficult because of wide variations in patient populations, extent of disease, coexisting conditions, and severity categorization between centers.

Of those patients who survive, 50% develop a long-term complication. The 2 most common complications are intestinal stricture and short-gut syndrome.

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