Gastroschisis: one year outcomes from national cohort study

INTRODUCTION There is a lack of knowledge on the average length of stay (LOS) in neonatal units after surgical repair of common congenital anomalies. There are few if any publications reporting the activity performed by units undertaking neonatal surgery. Such activity is important for contracting arrangements, commissioning specialist services and counselling parents. The aim of this study was to describe postnatal LOS for infants admitted to a single tertiary referral neonatal unit with congenital malformations requiring surgery. METHODS Data on nine conditions were collected prospectively for babies on the neonatal unit over a five-year period (2006)(2007)(2008)(2009)(2010)(2011). For those transferred back to their local unit following surgery, the local unit was contacted to determine the total LOS. Only those babies who had surgery during their first admission to our unit and who survived to discharge were included in the study. Cost estimates were based on the tariffs agreed for neonatal care between our trust and the London specialised commissioning group in 2011-2012. RESULTS The median LOS for the conditions studied was: gastroschisis 35 days (range: 19-154 days), oesophageal atresia 33 days (range: 9-133 days), congenital diaphragmatic hernia 28 days (range: 7-99 days), intestinal atresia 24 days (range: 6-168 days), Hirschsprung's disease 21 days (range: 15-36 days), sacrococcygeal teratoma 17 days (range: 12-55 days), myelomeningocoele 15.5 days (range: 8-24 days), anorectal malformation 15 days (range: 6-90 days) and exomphalos 12 days (range: 3-228 days). The total neonatal bed day costs for the median LOS ranged from £8,701 (myelomeningocoele) to £23,874 (gastroschisis). The cost of surgery was not included. CONCLUSIONS There is wide variation in LOS for the same conditions in a single neonatal unit. This can be explained by different types and severity within the same congenital anomalies, different surgeons and other clinical confounders (eg sepsis, surgical complications, associated anomalies). These data will enable us to give more detailed information to families following prenatal or postnatal diagnosis. They also allow more detailed planning of resource allocation for neonatal admissions.

show abstract

“…1 The data for 106 live births in 16 paediatric centres were reviewed and the mean survivor LOS was 46 days.…”

Section: Gastroschisismentioning

confidence: 99%

Length of stay and cost analysis of neonates undergoing surgery at a tertiary neonatal unit in England

Shetty

Kennea

Desai

et al. 2016

annals

View full text Add to dashboard Cite

show abstract

“…2,[4][5][6] Different surgical techniques (primary vs staged closure) to repair this abdominal wall defect did not show significant differences in outcomes. 2 In developed countries, prenatal diagnosis allows a 90% detection rate of gastroschisis within the second trimester of pregnancy. 7 A regular ultrasound monitoring of the fetus with gastroschisis aims to define size and quality of the herniated intestine (bowel dilatation or thickening), amount of amniotic fluid, and fetal growth.…”

mentioning

confidence: 99%

“…1,2 In contrast, complex gastroschisis (intestinal atresia, necrosis, or perforation) is associated with worse survival rate (70%-80%), longer hospital stay, and higher longterm morbidity. 2,3 The highly variable return to functional bowel (due to chronic intestinal inflammation) and the occurrence of bowel atresia (BA; requiring intestinal surgery in ∼10%-20% of cases) are the main factors affecting length of hospital stay (LOS) as well as total parenteral nutrition (TPN) dependence and associated neonatal complications (ie, recurrent sepsis, TPN cholestasis, adhesive bowel obstruction). 2,[4][5][6] Different surgical techniques (primary vs staged closure) to repair this abdominal wall defect did not show significant differences in outcomes.…”

mentioning

confidence: 99%

Prenatal Risk Factors and Outcomes in Gastroschisis: A Meta-Analysis

et al. 2015

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVE: Gastroschisis is a congenital anomaly with increasing incidence, easy prenatal diagnosis and extremely variable postnatal outcomes. Our objective was to systematically review the evidence regarding the association between prenatal ultrasound signs (intraabdominal bowel dilatation [IABD], extraabdominal bowel dilatation, gastric dilatation [GD], bowel wall thickness, polyhydramnios, and small for gestational age) and perinatal outcomes in gastroschisis (bowel atresia, intra uterine death, neonatal death, time to full enteral feeding, length of total parenteral nutrition and length of in hospital stay).

show abstract

“…Bu etkilenme sonucu bağırsaklardaki fonksiyon bozukluğu olur ve enteral beslenmeye geçiş gecikir (89) .…”

Section: Bağirsaklardaki̇ Deği̇şi̇kli̇kler Ve öNleme çAlişmalariunclassified

Abdominal wall defects: omphalocele and gastrschisis

Yazıcı¹

2017

tcdd

View full text Add to dashboard Cite

show abstract

Gastroschisis: one year outcomes from national cohort study

Abstract: Objective To describe one year outcomes for a national cohort of infants with gastroschisis.

Cited by 144 publications

References 30 publications

Length of stay and cost analysis of neonates undergoing surgery at a tertiary neonatal unit in England

Length of stay and cost analysis of neonates undergoing surgery at a tertiary neonatal unit in England

Prenatal Risk Factors and Outcomes in Gastroschisis: A Meta-Analysis

Abdominal wall defects: omphalocele and gastrschisis

Contact Info

Product

Resources

About