AI Article Synopsis
- - The study focused on simple gastroschisis patients without additional complications, analyzing factors impacting their health outcomes using data from a national registry between 2005 and 2013.
- - Of the 700 patients examined, 98.6% survived, with notable use of total parenteral nutrition (TPN) and hospital stays varying based on certain health metrics.
- - Key findings showed that prenatal bowel dilation, older age at closure, and CLABSI significantly affected recovery, with CLABSI emerging as the strongest predictor of extended TPN duration and hospital stays.
Article Abstract
Purpose: We analyzed the determinants of outcomes in simple gastroschisis (GS) not complicated by intestinal atresia, perforation, or necrosis.
Methods: All simple GS patients enrolled in a national prospective registry from 2005 to 2013 were studied. Patients below the median for total parenteral nutrition (TPN) duration (26days) and hospital stay (34days) were compared to those above. Univariate and multivariate logistic and linear regression analyses were employed using maternal, patient, postnatal, and treatment variables.
Results: Of 700 patients with simple GS, representing 76.8% of all GS patients, 690 (98.6%) survived. TPN was used in 352 (51.6%) and 330 (48.4%) patients for ≤26 and >26days, respectively. Hospital stay for 356 (51.9%) and 330 (48.1%) infants was ≤34 and >34days, respectively. Univariate analysis revealed significant differences in several patient, treatment, and postnatal factors. On multivariate analysis, prenatal sonographic bowel dilation, older age at closure, necrotizing enterocolitis, longer mechanical ventilation, and central-line associated blood stream infection (CLABSI) were independently associated with longer TPN duration and hospital stay, with CLABSI being the strongest predictor.
Conclusions: Prenatal bowel dilation is associated with increased morbidity in simple GS. CLABSI is the strongest predictor of outcomes. Bowel matting is not an independent risk factor.
Level Of Evidence: 2c.
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| http://dx.doi.org/10.1016/j.jpedsurg.2017.01.019 | DOI Listing |
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