Original ArticleThe association of type of surgical closure on length of stay among infants with gastroschisis born ≥ 34 weeks’ gestation
Section snippets
Materials & methods
The CHND captures clinical data on all infants admitted to 27 participating regional NICUs. Variables were defined prospectively, and chart abstractors at each site undergo prospective training including review of clinical definitions, participation in web-based seminar tutorials, and case-based practice. Since 2010, both initial and semi-annual measurements of inter-rater agreement scores are calculated at each site; over 90% intra-site concordance in abstraction is required for initial and
Results
Of the 28,299 infants in the CHND, 602 had GS during the study period. After sequentially excluding those born < 34 weeks’ gestation (n = 66), those admitted after their second day of life (n = 10) and those who died (n = 3), we then omitted those with major congenital heart disease (n = 3), congenital neurological disorders (n = 4), bowel atresia (n = 39), other markers of complex GS (n = 10), and those without data available on the type of received closure (n = 25). Of the infants who died, one had bilateral
Discussion
Gastroschisis is one of the most common congenital anomalies requiring surgery [1], [28]. With a rising incidence, understanding the implications of the current management strategies is critical to optimize these infants’ outcomes while minimizing unnecessary resource utilization. In this large, multi-center cohort of infants with uncomplicated GS born ≥ 34 weeks’ gestation, our study demonstrates that staged closure was associated with a greater LOS independent of patient characteristics [29].
Acknowledgments
Jeanette Asselin, David Durand, Francine Dykes, Jacquelyn Evans (Chair), Karna Murthy, Michael Padula, Eugenia Pallotto, Kristina Reber and Billie Short are members of the Children’s Hospitals Neonatal Consortium, Inc. (CHNC: http://www.TheCHNC.org). The CHNC has partnered with Children’s Hospital Association, Inc (Overland Park, KS, Alexandria, VA) in order to design, launch, and maintain the CHND.
We are indebted to the following institutions that serve the infants and their families, and
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