Improving gastroschisis outcomes

Does birth place matter?

Kate B. Savoie, Eunice Huang, Shahroz K. Aziz, Martin L. Blakely, Sid Dassinger, Amanda R. Dorale, Eileen M. Duggan, Matthew T. Harting, Troy A. Markel, Stacey D. Moore-Olufemi, Sohail R. Shah, Shawn D. St. Peter, Koujen Tsao, Deidre L. Wyrick, Regan Williams

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Purpose Babies born in the hospital where they obtain definitive surgical care do not require transportation between institutions and may have shorter time to surgical intervention. Whether these differences result in meaningful improvement in outcomes has been debated. A multi-institutional retrospective study was performed comparing outcomes based on birthplace. Methods Six institutions within the PedSRC reviewed infants born with gastroschisis from 2008 to 2013. Birthplace, perinatal, and postoperative data were collected. Based on the P-NSQIP definition, inborn was defined as birth at the pediatric hospital where repair occurred. The primary outcome was days to full enteral nutrition (FEN; 120 kcal/kg/day). Results 528 patients with gastroschisis were identified: 286 inborn, 242 outborn. Days to FEN, time to bowel coverage and abdominal wall closure, primary closure rate, and length of stay significantly favored inborn patients. In multivariable analysis, birthplace was not a significant predictor of time to FEN. Gestational age, presence of atresia or necrosis, primary closure rate, and time to abdominal wall closure were significant predictors. Conclusions Inborn patients had bowel coverage and definitive closure sooner with fewer days to full feeds and shorter length of stay. Birthplace appears to be important and should be considered in efforts to improve outcomes in patients with gastroschisis.

Original languageEnglish (US)
Pages (from-to)1771-1775
Number of pages5
JournalJournal of Pediatric Surgery
Volume49
Issue number12
DOIs
StatePublished - Dec 1 2014

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Gastroschisis
Abdominal Wall
Length of Stay
Pediatric Hospitals
Enteral Nutrition
Gestational Age
Necrosis
Retrospective Studies
Parturition

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Improving gastroschisis outcomes : Does birth place matter? / Savoie, Kate B.; Huang, Eunice; Aziz, Shahroz K.; Blakely, Martin L.; Dassinger, Sid; Dorale, Amanda R.; Duggan, Eileen M.; Harting, Matthew T.; Markel, Troy A.; Moore-Olufemi, Stacey D.; Shah, Sohail R.; St. Peter, Shawn D.; Tsao, Koujen; Wyrick, Deidre L.; Williams, Regan.

In: Journal of Pediatric Surgery, Vol. 49, No. 12, 01.12.2014, p. 1771-1775.

Research output: Contribution to journalArticle

Savoie, KB, Huang, E, Aziz, SK, Blakely, ML, Dassinger, S, Dorale, AR, Duggan, EM, Harting, MT, Markel, TA, Moore-Olufemi, SD, Shah, SR, St. Peter, SD, Tsao, K, Wyrick, DL & Williams, R 2014, 'Improving gastroschisis outcomes: Does birth place matter?', Journal of Pediatric Surgery, vol. 49, no. 12, pp. 1771-1775. https://doi.org/10.1016/j.jpedsurg.2014.09.019
Savoie KB, Huang E, Aziz SK, Blakely ML, Dassinger S, Dorale AR et al. Improving gastroschisis outcomes: Does birth place matter? Journal of Pediatric Surgery. 2014 Dec 1;49(12):1771-1775. https://doi.org/10.1016/j.jpedsurg.2014.09.019
Savoie, Kate B. ; Huang, Eunice ; Aziz, Shahroz K. ; Blakely, Martin L. ; Dassinger, Sid ; Dorale, Amanda R. ; Duggan, Eileen M. ; Harting, Matthew T. ; Markel, Troy A. ; Moore-Olufemi, Stacey D. ; Shah, Sohail R. ; St. Peter, Shawn D. ; Tsao, Koujen ; Wyrick, Deidre L. ; Williams, Regan. / Improving gastroschisis outcomes : Does birth place matter?. In: Journal of Pediatric Surgery. 2014 ; Vol. 49, No. 12. pp. 1771-1775.
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