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Predictive Factors for Postoperative Outcome in Children with Jejunoileal Atresia

Background  Jejunoileal atresia is a relatively rare congenital gastrointestinal requiring surgery and long postoperative care. The postoperative outcome is affected by many factors and this study focuses on finding predictors for time to full enteral feeding, length of hospital stay (LOH), and post...

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Autores principales: Jarkman, Charlotta, Salö, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Medical Publishers 2019
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6773588/
https://www.ncbi.nlm.nih.gov/pubmed/31579829
http://dx.doi.org/10.1055/s-0039-1697628
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author Jarkman, Charlotta
Salö, Martin
author_facet Jarkman, Charlotta
Salö, Martin
author_sort Jarkman, Charlotta
collection PubMed
description Background  Jejunoileal atresia is a relatively rare congenital gastrointestinal requiring surgery and long postoperative care. The postoperative outcome is affected by many factors and this study focuses on finding predictors for time to full enteral feeding, length of hospital stay (LOH), and postoperative complications. Methods  This was a retrospective study of all children operated for isolated jejunoileal atresia between 2001 and 2017 at a tertiary center of pediatric surgery. Independent variables regarding demographical-, operative-, and postoperative data were abstracted. Primary outcome was time to full enteral feeding, LOH, and postoperative complications in terms of reoperation or central line complication. Any significant variables from the univariate analysis were further analyzed with logistic regression and presented as odds ratio with 95% confidence interval. Results  After exclusion because of concomitant gastroschisis ( n  = 1), and death before discharge ( n  = 2), 47 patients were further analyzed (49% boys, 53% premature). No significant differences could be seen in the univariate analysis between children with short and long time (median > 17 days) to full enteral nutrition. Patients with longer LOH (median >32 days) had significantly lower birth weight compared with those with shorter LOH; median 2,550 g versus 2,980 g ( p  = 0.04). Patients with a central line complication had significantly longer median time to full enteral feeding (median 27 vs. 12 days, p  = 0.03), and significantly longer median LOH (median 43 vs. 21 days, p  = 0.03), but these parameters were not significant in a multivariate analysis. No significant results were found regarding reoperation. Conclusion  Low birth weight seems associated with an increased LOH in children operated on for jejunoileal atresia, and central line complications seem related to the duration with central line in this group. The small cohort may constitute a power problem in this study and further research regarding the included variables may reveal more potential predictors for the postoperative outcome.
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spelling pubmed-67735882019-10-02 Predictive Factors for Postoperative Outcome in Children with Jejunoileal Atresia Jarkman, Charlotta Salö, Martin Surg J (N Y) Background  Jejunoileal atresia is a relatively rare congenital gastrointestinal requiring surgery and long postoperative care. The postoperative outcome is affected by many factors and this study focuses on finding predictors for time to full enteral feeding, length of hospital stay (LOH), and postoperative complications. Methods  This was a retrospective study of all children operated for isolated jejunoileal atresia between 2001 and 2017 at a tertiary center of pediatric surgery. Independent variables regarding demographical-, operative-, and postoperative data were abstracted. Primary outcome was time to full enteral feeding, LOH, and postoperative complications in terms of reoperation or central line complication. Any significant variables from the univariate analysis were further analyzed with logistic regression and presented as odds ratio with 95% confidence interval. Results  After exclusion because of concomitant gastroschisis ( n  = 1), and death before discharge ( n  = 2), 47 patients were further analyzed (49% boys, 53% premature). No significant differences could be seen in the univariate analysis between children with short and long time (median > 17 days) to full enteral nutrition. Patients with longer LOH (median >32 days) had significantly lower birth weight compared with those with shorter LOH; median 2,550 g versus 2,980 g ( p  = 0.04). Patients with a central line complication had significantly longer median time to full enteral feeding (median 27 vs. 12 days, p  = 0.03), and significantly longer median LOH (median 43 vs. 21 days, p  = 0.03), but these parameters were not significant in a multivariate analysis. No significant results were found regarding reoperation. Conclusion  Low birth weight seems associated with an increased LOH in children operated on for jejunoileal atresia, and central line complications seem related to the duration with central line in this group. The small cohort may constitute a power problem in this study and further research regarding the included variables may reveal more potential predictors for the postoperative outcome. Thieme Medical Publishers 2019-10-01 /pmc/articles/PMC6773588/ /pubmed/31579829 http://dx.doi.org/10.1055/s-0039-1697628 Text en https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Jarkman, Charlotta
Salö, Martin
Predictive Factors for Postoperative Outcome in Children with Jejunoileal Atresia
title Predictive Factors for Postoperative Outcome in Children with Jejunoileal Atresia
title_full Predictive Factors for Postoperative Outcome in Children with Jejunoileal Atresia
title_fullStr Predictive Factors for Postoperative Outcome in Children with Jejunoileal Atresia
title_full_unstemmed Predictive Factors for Postoperative Outcome in Children with Jejunoileal Atresia
title_short Predictive Factors for Postoperative Outcome in Children with Jejunoileal Atresia
title_sort predictive factors for postoperative outcome in children with jejunoileal atresia
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6773588/
https://www.ncbi.nlm.nih.gov/pubmed/31579829
http://dx.doi.org/10.1055/s-0039-1697628
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