Evidence map›Paper›PMID 41073926›Full record

ArticleBMC gastroenterology2025

Predicting surgical NEC in neonates: risk factors and model development.

Mingyun Tang, Xiaofei Ma, Yuan Gan, Yanxing Lv, Yunzhi Liu, Yongjiang Jiang, Xiaolan Li, Yueju Cai

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Necrotizing enterocolitis.Nature reviews. Disease primers · 2026
    Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Mingyun TangDepartment of Neonatology, Guangzhou Wowen and Children's Medical Center, Liuzhou hospital, Liuzhou, 545001, China.
Xiaofei MaDepartment of Neonatology, Guangzhou Wowen and Children's Medical Center, Liuzhou hospital, Liuzhou, 545001, China.
Yuan GanDepartment of Neonatology, Guangzhou Wowen and Children's Medical Center, Liuzhou hospital, Liuzhou, 545001, China.
Yanxing LvDepartment of Neonatology, Guangzhou Wowen and Children's Medical Center, Liuzhou hospital, Liuzhou, 545001, China.
Yunzhi LiuDepartment of Neonatology, Guangzhou Wowen and Children's Medical Center, Liuzhou hospital, Liuzhou, 545001, China.
Yongjiang JiangDepartment of Neonatology, Guangzhou Wowen and Children's Medical Center, Liuzhou hospital, Liuzhou, 545001, China.
Xiaolan LiDepartment of Neonatology, Guangzhou Wowen and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China. lixiaolan0620@163.com.
Yueju CaiDepartment of Neonatology, Guangzhou Wowen and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China. caiyueju0323@163.com.

Funding

Guangzhou Health Science and Technology Project Grant No. 20241A011025Liuzhou Science and Technology Planning Project Grant No. 2024SB 0104A002Wu Jieping Medical Foundation Clinical Research Special Funding Grant No.320.6750.2025-9-15
6 · The paper itself

Abstract

backgroundNeonatal necrotizing enterocolitis (NEC) is a severe gastrointestinal emergency associated with high morbidity and mortality in neonates. Early identification of cases requiring surgical intervention is critical to improving outcomes.

objectiveTo identify independent risk factors associated with surgical treatment in neonates with NEC and to develop a predictive model that supports timely surgical decision-making and enhances prognosis.

methodsThis retrospective study included 188 neonates diagnosed with NEC (Bell stage II or higher) at Liuzhou Hospital, Guangzhou Women and Children's Medical Center between December 2018 and December 2024. Patients were categorized into a surgical treatment group (n = 70) and a conservative treatment group (n = 118). Least absolute shrinkage and selection operator (LASSO) regression and multivariable logistic regression were used to identify independent risk factors. A nomogram was developed based on these factors. Model performance was assessed using receiver operating characteristic (ROC) curve analysis, calibration curve, and decision curve analysis (DCA).

resultsAmong the 188 neonates, 70 (37.2%) underwent surgery. The mortality rate was significantly higher in the surgical group compared to the conservative group (17.1% vs. 1.1%). Multivariable analysis identified C-reactive protein (CRP), serum lactate, portal venous gas, reduced intestinal motility, white blood cell count, and absolute lymphocyte count as independent predictors of surgical intervention. The nomogram model demonstrated excellent discrimination (AUC = 0.946, 95% CI: 0.911-0.981), with a sensitivity of 0.914 and specificity of 0.890. Calibration and DCA confirmed strong clinical utility.

conclusionThis study established a nomogram-based predictive model for surgical treatment in NEC, utilizing six indicators: CRP, serum lactate, portal venous gas, reduced intestinal motility, white blood cell count, and absolute lymphocyte count. The model shows high accuracy and clinical utility. It can assist clinicians in predicting the need for surgery at the early stages of NEC, optimizing treatment decisions, reducing mortality, and improving the prognosis of affected neonates.

Indexed as

Enterocolitis, NecrotizingNomogramsC-Reactive ProteinFemaleHumansInfant, NewbornLeukocyte CountMalePrognosisRetrospective StudiesRisk FactorsROC CurveC-Reactive ProteinNECNeonatesPredictive modelRisk factorsSurgical treatment

Identifiers

PMID41073926
PMCPMC12512803

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.