Revisiting NEC Risk Awareness with a Refined GutCheckNEC (102)

Necrotizing enterocolitis (NEC) risk has been shown to arise from multiple sources and risk awareness may be supported using bedside tools.The purpose of this session will be to review research and practice evidence about necrotizing enterocolitis risk and present new findings that examine the extent to which GutCheckNEC related to scores for clinical deterioration, severity of illness, and clinical outcome. Findings from early studies on NEC risk will provide context for a retrospective, correlational case-control study with infant data from three affiliated NICUs that was conducted. Results showed that at 68 hours of life, poorer GutCheckNEC scores were associated with NEC requiring surgery or resulting in death (Relative risk ratio [RRR] = 1.06, P = 0.036), associations which persisted at 24 hours prior to diagnosis (RRR = 1.05, P = 0.046); and at the time of diagnosis (RRR = 1.05, P = 0.022) but showed no associations for medical NEC. GutCheckNEC scores were significantly correlated with PEWS scores (r > 0.30; P < 0.005) and SNAPPE-II scores (r > 0.44, P < 0.0001). Increasing numbers of clinical signs and symptoms were positively associated with GutCheckNEC and PEWS scores at time of diagnosis (r=0.19, p=0.026; and r=0.25, p=0.005, respectively), but not with SNAPPE II scores. Implications for practice include the need to use caution and not use GutCheckNEC as a diagnostic tool. Yet, it can still be valuable as a communication aid to streamline communication for NEC risk awareness.