The association of perinatal and clinical factors with outcomes in infants with gastroschisis-a retrospective multicenter study in Finland.
Eur J Pediatr
; 180(6): 1875-1883, 2021 Jun.
Article
em En
| MEDLINE
| ID: mdl-33532890
ABSTRACT
The aim of the present study was to assess the prognostic factors for the outcome of gastroschisis in Finland. A retrospective multicenter study of gastroschisis patients born between 1993 and 2015 in four Finnish university hospitals was undertaken, collecting perinatal, surgical, and clinical data of neonates for uni- and multifactorial modeling analysis. The aim of the present study was to identify risk factors for mortality and the composite adverse outcome (death and/or short bowel syndrome or hospital stay > 60 days). Of the 154 infants with gastroschisis, the overall survival rate was 90.9%. In Cox regression analysis, independent risk factors for mortality included liver herniation, pulmonary hypoplasia, relaparotomy for perforation or necrosis, abdominal compartment syndrome, and central line sepsis. Furthermore, a logistic regression analysis identified central line sepsis, abdominal compartment syndrome, complex gastroschisis, and a younger gestational age as independent predictors of the composite adverse outcome.Conclusion:
The risk of death is increased in newborns with gastroschisis who have liver herniation, pulmonary hypoplasia, abdominal compartment syndrome, relaparotomy for perforation or necrosis, or central line-associated sepsis. Special care should be taken to minimize the risk of central line sepsis in the clinical setting. What is known ⢠Gastroschisis is a relatively rare congenital anomaly of the abdominal wall and its incidence is increasing. ⢠Complex gastroschisis has been reported to increase risk of mortality and complications. What is new ⢠Central line sepsis was found to be independently associated with mortality in gastroschisis patients. ⢠Liver herniation was also significantly associated with mortality.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Gastrosquise
Tipo de estudo:
Etiology_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Female
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Humans
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Infant
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Newborn
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Pregnancy
País/Região como assunto:
Europa
Idioma:
En
Revista:
Eur J Pediatr
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Finlândia