Division of Pediatric Surgery, SSM Health Cardinal Glennon Children's Hospital, Saint Louis University School of Medicine, 1465 S Grand Blvd., St. Louis, MO, 63104, USA.
Pediatr Surg Int. 2022 Oct;38(10):1371-1376. doi: 10.1007/s00383-022-05189-w. Epub 2022 Jul 25.
We aimed to assess predictors of length of stay for simple gastroschisis utilizing the NSQIP-Pediatric Database.
The NSQIP-P Participant Use Data File was queried to identify patients with simple gastroschisis. We defined short length of stay (LOS) as patients discharged home ≤ 30 days from birth. We compared patients with short LOS versus prolonged LOS > 30 days. Predictors and outcomes were evaluated.
There were 888 patients with simple gastroschisis identified. Half of patients had LOS ≤ 30 days. Patients with LOS ≤ 30 were younger at repair (median age 1 day vs. 3 days, p = 0.0001), had higher birth weight (median 2.5 kg vs. 2.4 kg, p = 0.0001), and were less premature (37 week vs. 36 weeks, p = 0.0001). However, only gestational age and weight at birth were significant predictors of LOS on multivariate analysis (p = 0.0001). Prolonged LOS patients had more instances of ventilation, oxygen supplementation, sepsis (n = 2/446 or 0.4% vs. n = 9/442 or 2%, p = 0.003), bleeding/transfusion (n = 7/446 or 1.6% vs. n = 43/442 or 9.7%, p = 0.0001), line infections (n = 1/446 or 0.2% vs. n = 12/442, p = 0.001), and reoperations (n = 9/446 or 2% vs. n = 26/442 or 5.9%, p = 0.003).
Prematurity and birth weight are significant predictors of length of stay in simple gastroschisis patients. Prenatal counseling should continue to be one of the main factors to improve the outcomes for patients with gastroschisis. Type of study Retrospective cohort study. Level of evidence Level IV.
我们旨在利用 NSQIP-儿科数据库评估单纯性腹裂的住院时间的预测因素。
查询 NSQIP-参与者使用数据文件以确定单纯性腹裂患者。我们将短住院时间（LOS）定义为出生后≤30 天出院的患者。我们比较了 LOS 短（LOS≤30 天）和 LOS 长（LOS>30 天）的患者。评估了预测因素和结果。
确定了 888 例单纯性腹裂患者。一半的患者 LOS≤30 天。LOS≤30 天的患者修复时年龄更小（中位数 1 天 vs. 3 天，p=0.0001），出生体重更高（中位数 2.5 公斤 vs. 2.4 公斤，p=0.0001），且更不成熟（37 周 vs. 36 周，p=0.0001）。但是，只有胎龄和出生体重是 LOS 的多变量分析的显著预测因素（p=0.0001）。LOS 延长的患者通气、氧补充、败血症（n=2/446 或 0.4%vs. n=9/442 或 2%，p=0.003）、出血/输血（n=7/446 或 1.6%vs. n=43/442 或 9.7%，p=0.0001）、置管感染（n=1/446 或 0.2%vs. n=12/442，p=0.001）和再次手术（n=9/446 或 2%vs. n=26/442 或 5.9%，p=0.003）的发生率更高。
早产和出生体重是单纯性腹裂患者住院时间的显著预测因素。产前咨询应继续作为改善腹裂患者结局的主要因素之一。
回顾性队列研究。
IV 级。
