Variability in age at Kasai portoenterostomy for biliary atresia across US children's hospitals.
J Pediatr Surg
; 56(6): 1196-1202, 2021 Jun.
Article
em En
| MEDLINE
| ID: mdl-33838903
ABSTRACT
BACKGROUND/PURPOSE:
The purpose of this study was to assess variability in age at Kasai portoenterostomy (KP) in infants with biliary atresia (BA) across children's hospitals in the United States. STUDYDESIGN:
A multi-institutional retrospective study was performed examining infants with BA undergoing KP within 6 months of birth from 2016-2019, utilizing the Pediatric Health Information System (PHIS). Multivariable negative binomial mixed effects regression was performed for age at KP, and inter-hospital variability was examined.RESULTS:
Across 46 hospitals, 470 infants with BA underwent KP at a median age of 57 days (IQR 42-72), with 212 (45.1%) undergoing KP at ≥60 days of age. There was significant inter-hospital variability in age at KP ranging from 38 days (95% CI 31d, 47d) to 76 days (95% CI 63d, 91d) (p<0.0001). Factors associated with later KP were black or African-American race, urgent/emergent admission, and treatment at a hospital in the Pacific-West region. Predictors of earlier KP included later year, history of neonatal comorbidity, and admission to an intensive care service (all p<0.05).CONCLUSION:
There is significant variability in the age at KP in infants with BA across children's hospitals in the United States. TYPE OF STUDY Retrospective study. LEVEL OF EVIDENCE III.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Atresia Biliar
/
Transplante de Fígado
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Child
/
Humans
/
Infant
/
Newborn
Idioma:
En
Revista:
J Pediatr Surg
Ano de publicação:
2021
Tipo de documento:
Article