TY - JOUR
T1 - Effect of time to surgical evaluation on the outcomes of infants with gastroschisis
AU - Bucher, Brian T.
AU - Mazotas, Ioanna G.
AU - Warner, Brad W.
AU - Saito, Jacqueline M.
PY - 2012/6
Y1 - 2012/6
N2 - Purpose: Our goal is to identify the impact of time to surgical intervention on the outcomes of infants with gastroschisis. Methods: After institutional review board approval, we performed a retrospective review of the medical records of all infants admitted to our institution from 2001 to 2010. Transport, bowel stabilization, and closure times were defined as the time from birth to admission, admission to the first-documented operative intervention, and first operative intervention to abdominal closure, respectively. Outcomes included age at full enteral feeds, total parental nutrition days, ventilator days, and hospital length of stay. Multivariate analysis was used to identify independent predictors of the outcomes. Results: One hundred eighteen infants with gastroschisis were included in our study. Transport and bowel stabilization times were not predictive of any outcome. However, the time to abdominal wall closure and postnatal gastrointestinal complications were independently predictive of age at full enteral feeds, total parenteral nutrition days, and hospital length of stay. Conclusion: Time to surgical evaluation/bowel stabilization was not predictive of any clinically relevant outcomes in infants with gastroschisis. These data demonstrate that potential benefits from prenatal regionalization of infants with gastroschisis are not supported by decreased time to operative intervention.
AB - Purpose: Our goal is to identify the impact of time to surgical intervention on the outcomes of infants with gastroschisis. Methods: After institutional review board approval, we performed a retrospective review of the medical records of all infants admitted to our institution from 2001 to 2010. Transport, bowel stabilization, and closure times were defined as the time from birth to admission, admission to the first-documented operative intervention, and first operative intervention to abdominal closure, respectively. Outcomes included age at full enteral feeds, total parental nutrition days, ventilator days, and hospital length of stay. Multivariate analysis was used to identify independent predictors of the outcomes. Results: One hundred eighteen infants with gastroschisis were included in our study. Transport and bowel stabilization times were not predictive of any outcome. However, the time to abdominal wall closure and postnatal gastrointestinal complications were independently predictive of age at full enteral feeds, total parenteral nutrition days, and hospital length of stay. Conclusion: Time to surgical evaluation/bowel stabilization was not predictive of any clinically relevant outcomes in infants with gastroschisis. These data demonstrate that potential benefits from prenatal regionalization of infants with gastroschisis are not supported by decreased time to operative intervention.
KW - Gastroschisis
KW - Outcome
KW - Transport
UR - http://www.scopus.com/inward/record.url?scp=84862507059&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2012.03.016
DO - 10.1016/j.jpedsurg.2012.03.016
M3 - Article
C2 - 22703778
AN - SCOPUS:84862507059
VL - 47
SP - 1105
EP - 1110
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 6
ER -