Ling Con Yee, Zaniletti Isabella, Riddle Stefanie, Elizabeth Jacobson, Korff Stephanie G, Chandler Angela L, Downey L Corbin, Padula Michael A, Evans Jacquelyn R, Grover Theresa R, Murthy Karna
Division of Neonatology, University of Utah School of Medicine, Salt Lake City, UT, USA.
Children's Hospitals Neonatal Consortium, Dover, DE, USA.
J Perinatol. 2024 Dec 11. doi: 10.1038/s41372-024-02160-6.
To estimate inter-center variation (ICV) in hospital length of stay (LOS) and oral feeding at discharge among infants with gastroschisis.
The Children's Hospitals Neonatal Consortium's (CHNC) database was used to identify hospitalized survivors with gastroschisis. Two outcomes were evaluated: LOS and discharge without tube feedings. Hospital outcomes were evaluated in unadjusted and adjusted analyses. Generalized linear models with log link for gamma distribution were used to model LOS and logistic regression for discharge without tube feeds.
For 3987 surviving infants with gastroschisis, LOS and discharge within 70 days with exclusively oral feeding both exhibited significant ICV. Differences persisted in multivariable analyses. Risk-adjusted LOS (68% difference) and oral feeding at discharge (6.4-fold difference) varied significantly between centers.
Hospital of care was independently associated with LOS and exclusive oral feeding at discharge rates for infants with gastroschisis. Management differences, potentially influenced by parental preferences, contributed to variation.
评估先天性腹裂婴儿住院时间（LOS）及出院时经口喂养情况的中心间差异（ICV）。
利用儿童医院新生儿联盟（CHNC）数据库确定住院的先天性腹裂存活患儿。评估了两个结局：住院时间和无管饲出院。对医院结局进行了未调整和调整分析。采用对数连接的广义线性模型对伽马分布进行建模以分析住院时间，采用逻辑回归分析无管饲出院情况。
对于3987例存活的先天性腹裂婴儿，住院时间和70天内完全经口喂养出院均显示出显著的中心间差异。多变量分析中差异依然存在。各中心间风险调整后的住院时间（差异68%）和出院时经口喂养情况（差异6.4倍）差异显著。
对于先天性腹裂婴儿，所接受治疗的医院与住院时间及出院时完全经口喂养率独立相关。管理差异可能受家长偏好影响，导致了这种差异。
