Intraoperative Findings Associated to Inpatient Mortality From Patients With Gastroschisis in Western Mexico.
J Surg Res
; 254: 58-63, 2020 10.
Article
em En
| MEDLINE
| ID: mdl-32417497
ABSTRACT
BACKGROUND:
Intraoperative findings during gastroschisis surgery are the main predictor associated with increased mortality. The aim of our study was to determine the type of surgical findings associated with inpatient mortality in a cohort of patients with gastroschisis from a university hospital in Western Mexico. MATERIALS ANDMETHODS:
Infants with surgically repaired gastroschisis during the period 2011-2017 at the Dr. Juan I. Menchaca Civil Hospital of Guadalajara (Guadalajara, Mexico) were studied. Data regarding demographics, perinatal history, and intraoperative findings were collected and compared according to whether they were nonsurvivors (cases) or survivors (controls) at hospital discharge. Data were analyzed using logistic regression, determining its adjusted odds ratio (aOR) and its respective 95% confidence intervals (95% CIs). The proper adjustment of the model was verified using the Hosmer and Lemeshow test.RESULTS:
Ninety-four patients with gastroschisis were studied, of which 13 were nonsurvivors (13.8%), and 81 (86.2%) were survivors at hospital discharge. In the group of survivors, primary surgical closure was performed more frequently (P = 0.018), whereas staged reduction with a silo predominated in the group of nonsurvivors (P = 0.018), and an increased frequency of complex gastroschisis (0.0001). After logistic regression analysis, intraoperative findings associated with nonsurvival were severe bowel matting (aOR 7.3; 95% CI 1.2-44), and prolapse of the small intestine and large intestine, plus any other organ (aOR 15.9; 95% CI 1.1-219.6).CONCLUSIONS:
Mortality in our cohort was high (13.8%) and was significantly associated with severe bowel matting, and the prolapse of the small and large intestines, plus any other organ.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Gastrosquise
/
Pacientes Internados
Limite:
Female
/
Humans
/
Newborn
/
Pregnancy
País/Região como assunto:
Mexico
Idioma:
En
Revista:
J Surg Res
Ano de publicação:
2020
Tipo de documento:
Article