Predictors of postnatal outcome in neonates with gastroschisis.

Abstract:

BACKGROUND/PURPOSE:The optimal management of neonates with gastroschisis is unclear, and there is a significant morbidity. We performed a review of neonates with gastroschisis treated at our center of pediatric surgery over the last 21 years to determine predictive factors of outcome. METHODS:Single-center retrospective analysis of 79 neonates with gastroschisis (1989-2009) was done. Length of hospital stay (LOS), days of parenteral nutrition (PN), and survival were outcome measures. Univariate and multiple regression analyses were used. RESULTS:Overall survival was 92%, and primary closure was achieved in 80%. Median LOS was 25 days, and median duration on PN, 17 days. Intestinal atresia, closed gastroschisis, secondary closure, and sepsis were the primary variables associated with poor outcome independent of other variables, but prematurity also affected outcome. Route of delivery and associated malformations were not related to poorer outcome. Necrotizing enterocolitis did not occur in any of our patients. CONCLUSION:Outcome in our patients was favorable as measured by survival, LOS, and days on PN. Primary predictors of poor outcome were factors related to short bowel syndrome and secondary closure, indicating a need to further improve treatment of short bowel syndrome.

journal_name

J Pediatr Surg

authors

Kassa AM,Lilja HE

doi

10.1016/j.jpedsurg.2011.07.012

subject

Has Abstract

pub_date

2011-11-01 00:00:00

pages

2108-14

issue

11

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(11)00631-2

journal_volume

46

pub_type

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