Department of Surgery, University of Illinois College of Medicine, Peoria, IL, USA.
Department of Surgery, University of Illinois College of Medicine, Peoria, IL, USA.
J Pediatr Surg. 2020 May;55(5):855-860. doi: 10.1016/j.jpedsurg.2020.01.017. Epub 2020 Feb 4.
One of the most common procedures in the pediatric population is the placement of a gastrostomy tube. There are significant medical, emotional, and social implications for both patients and caregivers. We hypothesized that socioeconomic status had a significant impact on gastrostomy complications.
A retrospective chart review was performed. Patient and census data including median household income, unemployment rate, health insurance status, poverty level, and caregiver education level were merged. Statistical tests were conducted against a 2-sided alternative hypothesis with a 0.05 significance level. Outcomes examined were minor and major complications in association with socioeconomic variables.
Patients with mechanical complications were younger, weighed less, and had a 72% greater chance of having commercial insurance. Patients with Medicare/self-pay were three times more likely to have a minor complication. The average unemployment rate was 23% greater in families with a major complication. Individuals with a minor complication came from community tracts with a lower percentage of families below the poverty level.
An association between socioeconomic factors and gastrostomy complications was identified. Insurance status and employment status were more significant predictors than poverty level. Further work with variables for targeted interventions to provide specific family support will allow these children and families to thrive.
Level II prognosis study.
在儿科人群中，最常见的操作之一是放置胃造口管。这对患者和护理人员都有重大的医学、情感和社会影响。我们假设社会经济地位对胃造口并发症有重大影响。
进行了回顾性图表审查。患者和人口普查数据包括家庭收入中位数、失业率、医疗保险状况、贫困水平和护理人员教育水平。针对双侧备择假设进行了统计检验，显著性水平为 0.05。检查的结果是与社会经济变量相关的轻微和主要并发症。
患有机械性并发症的患者年龄较小，体重较轻，且有 72%的机会获得商业保险。有医疗保险/自付的患者发生轻微并发症的可能性增加了 3 倍。有主要并发症的家庭的平均失业率高 23%。患有轻微并发症的个体来自贫困水平以下家庭比例较低的社区地段。
确定了社会经济因素与胃造口并发症之间的关联。保险状况和就业状况是比贫困水平更重要的预测因素。进一步研究针对特定家庭的干预措施的变量，将为这些儿童和家庭提供更好的支持。
II 级预后研究。
