AUTHOR=Song Shuting , Zhang Jian , Zhao Yuwei , Dai Liying 

TITLE=Development and Validation of a Nomogram for Predicting the Risk of Bell's Stage II/III Necrotizing Enterocolitis in Neonates Compared to Bell's Stage I

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.863719

DOI=10.3389/fped.2022.863719

ISSN=2296-2360

ABSTRACT=Background: Early prediction and early diagnosis of Necrotizing Enterocolitis (NEC) are important for clinical management of NEC. The main objective of this study was to construct a nomogram model predicting the risk of neonatal NEC. 
Patients and Methods: A total of 730 NEC newborns diagnosed from January 2015 to January 2021 were retrospectively studied. They were randomly divided into training and validation groups in the ratio of 7:3. A nomogram model for predicting NEC was developed based on all independent risk factors by multivariate regression analysis. The model's performance was evaluated mainly through three aspects: the area under the curve (AUC) to verify discrimination, Hosmer-Lemeshow test and calibration curves to validate consistency, and the decision curve analysis (DCA) check clinical effectiveness.
Results: Predictors contained in the prediction model included gestational age (GA), birth weight(BW), asphyxia, septicemia, hypoglycemia, patent ductus arteriosus (PDA).  The nomogram model containing the above-mentioned six risk factors had good discrimination ability in both groups, and the AUC was 0.853 (95%CI, 0.82-0.89) and 0.846 (95% CI, 0.79-0.90), respectively. The calibration curve and DCA confirmed that the nomogram had a good consistency and clinical usefulness.
Conclusions: This individual prediction nomogram based on GA, BW, asphyxia, septicemia, hypoglycemia, PDA is a useful tool to predict NEC, which can help neonatologists identify NEC early and take some effective measures.
Keywords: Necrotizing enterocolitis, neonate, nomogram, risk factors, prediction model