A systematic review of the PubMed and EMBASE databases was carried out to determine if time from diagnosis to surgery affects outcomes in necrotising enterocolitis. The study was registered on the PROSPERO website. Studies reporting both time to surgery and at least one clinical outcome measure in infants undergoing surgery for NEC were included. The initial search returned 1121 articles. After removing duplicates, title, and abstract screening, 49 remained for full-text review. Of these, only two reported both timing of surgery for NEC and at least one clinical outcome. The total number of neonates included was 202. Outcomes reported were death and/or parenteral nutrition use 28 days post surgery in one study and white matter brain injury in the other. No statistically significant association was found between any of the outcomes reported and timing of surgery. There were, however, significant differences associated with non-modifiable risk factors, such as age and gestation, at presentation. However, very few studies report this as a variable. Given the continuing poor outcomes and heterogeneous nature of NEC and its treatments, further large-scale prospective studies are required to examine the impact of timing of surgery, alongside other, potentially modifiable factors on outcome in NEC.
Tattoos are an expression of personal style and identity that don't negate a doctor's professionalism, argues Bea Duric
Bea Duric intercalating medical studentThe days of white coat conservatism in the healthcare community are numbered. Or at least they are according to my worldly research supervisor who asks me for the story behind my latest half sleeve tattoo at the end of our meeting. Although I have never experienced any discrimination or criticism for my inked skin on the wards, my supervisor's comments offered a catharsis that I never knew I needed until that moment.
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