Association of neutropenia at disease onset with severe surgical necrotizing enterocolitis and higher mortality: A retrospective study

BackgroundNeutrophils are among the earliest immune cells recruited to the site of an intestinal injury, but their predictive role in the progression of necrotizing enterocolitis (NEC) has not been fully elucidated. This study aimed to evaluate if a reduction in neutrophils at the onset of NEC is associated with severe surgical NEC and/or NEC-associated deaths.MethodsThis is a retrospective cohort study in which neonates underwent surgery due to NEC during 2015–2020. The data on absolute neutrophil count (ANC), before and at the onset of NEC, were collected from the complete blood count results. The primary exposure was the difference in absolute neutrophil count (ΔANC) at NEC onset. The primary outcome was severe surgical NEC, defined as the residual small bowel length after intestinal resection of 0) was associated with adverse outcomes (hazard ratio [HR] 3.48, 95% CI 1.64–7.36) and a lower survival probability (χ2 10.63; P