Title

The Association Of Type Of Surgical Closure On Length Of Stay Among Infants With Gastroschisis Born ≥ 34 Weeks' Gestation

Keywords

Children's Hospital Neonatal Database (CHND); Children's Hospitals Neonatal Consortium; Gastroschisis; Infant; Length of stay; Neonatal intensive care; Staged closure

Abstract

Background/Purpose The optimal surgical approach in infants with gastroschisis (GS) is unknown. The purpose of this study was to estimate the association between staged closure and length of stay (LOS) in infants with GS. Design/Methods We used the Children's Hospital Neonatal Database to identify surviving infants with GS born ≥ 34 weeks' gestation referred to participating NICUs. Infants with complex GS, bowel atresia, or referred after 2 days of age were excluded. The primary outcome was LOS; multivariable linear regression was used to quantify the relationship between staged closure and LOS. Results Among 442 eligible infants, staged closure occurred in 68.1% and was associated with an increased median LOS relative to odds ration (OR):primary closure (37 vs. 28 days, p < 0.001). This association persisted in the multivariable equation (β = 1.35, 95% CI: 1.21, 1.52, p < 0.001) after adjusting for the presence of necrotizing enterocolitis, short bowel syndrome, and central-line associated bloodstream infections. Conclusions In this large, multicenter cohort of infants with GS, staged closure was independently associated with increased LOS. These data can be used to enhance antenatal and pre-operative counseling and also suggest that some infants who receive staged closure may benefit from primary repair. © 2014 Elsevier Inc.

Publication Date

1-1-2014

Publication Title

Journal of Pediatric Surgery

Volume

49

Issue

8

Number of Pages

1220-1225

Document Type

Article

Personal Identifier

scopus

DOI Link

https://doi.org/10.1016/j.jpedsurg.2013.12.020

Socpus ID

84905457919 (Scopus)

Source API URL

https://api.elsevier.com/content/abstract/scopus_id/84905457919

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