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Prognostic Factors Related to In-hospital Death in Children with Biliary Atresia: Analysis of a Nationwide Inpatient Database
BACKGROUND AND AIMS: Patients with biliary atresia (BA) are prone to hepatic decompensation, which might eventually lead to death. This study aimed to identify the possible risk factors affecting in-hospital death in BA patients in China. METHODS: We collected data from the Hospital Quality Monitori...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
XIA & HE Publishing Inc.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9817058/ https://www.ncbi.nlm.nih.gov/pubmed/36643040 http://dx.doi.org/10.14218/JCTH.2021.00456 |
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author | Shi, Yu Jiang, Yi-Zhou Zhou, Guang-Peng Shi, Ying Gan, Lan-Xia Kong, Yuan-Yuan Wang, Hai-Bo Zhu, Zhi-Jun Sun, Li-Ying |
author_facet | Shi, Yu Jiang, Yi-Zhou Zhou, Guang-Peng Shi, Ying Gan, Lan-Xia Kong, Yuan-Yuan Wang, Hai-Bo Zhu, Zhi-Jun Sun, Li-Ying |
author_sort | Shi, Yu |
collection | PubMed |
description | BACKGROUND AND AIMS: Patients with biliary atresia (BA) are prone to hepatic decompensation, which might eventually lead to death. This study aimed to identify the possible risk factors affecting in-hospital death in BA patients in China. METHODS: We collected data from the Hospital Quality Monitoring System, a national inpatient database. All patients aged up to 2 years old with a diagnosis of BA were included. The subjects were divided to three groups, including Kasai portoenterostomy (KP), liver transplantation (LT), and no surgery. Logistic regression with Firth’s method was performed to identify potential influencing variables associated with in-hospital death. RESULTS: During the year 2013 to 2017, there were 14,038 pediatric admissions with a diagnosis of BA. The proportion of in-hospital death in pediatric BA admissions was 1.08%. Compared with patients under six months, there was a higher risk of in-hospital death for children aged six months to 1 year and 1–2 years old. Clinical signs, including cirrhosis, variceal bleeding, and hepatic encephalopathy, were significantly associated with the risk of in-hospital death. In no surgery group, compared to those in Beijing and Shanghai, BA patients admitted in other districts had a lower risk of in-hospital death (OR=0.39, 95% CI: 0.21, 0.70). However, in the LT group, patients admitted in other districts had a higher risk of in-hospital death (OR=9.13, 95% CI: 3.99, 20.87). CONCLUSIONS: In-hospital survival remains unsatisfactory for pediatric BA patients with severe complications. Furthermore, more resources and training for BA treatment, especially LT, are essential for districts with poor medical care in the future. |
format | Online Article Text |
id | pubmed-9817058 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | XIA & HE Publishing Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-98170582023-01-13 Prognostic Factors Related to In-hospital Death in Children with Biliary Atresia: Analysis of a Nationwide Inpatient Database Shi, Yu Jiang, Yi-Zhou Zhou, Guang-Peng Shi, Ying Gan, Lan-Xia Kong, Yuan-Yuan Wang, Hai-Bo Zhu, Zhi-Jun Sun, Li-Ying J Clin Transl Hepatol Original Article BACKGROUND AND AIMS: Patients with biliary atresia (BA) are prone to hepatic decompensation, which might eventually lead to death. This study aimed to identify the possible risk factors affecting in-hospital death in BA patients in China. METHODS: We collected data from the Hospital Quality Monitoring System, a national inpatient database. All patients aged up to 2 years old with a diagnosis of BA were included. The subjects were divided to three groups, including Kasai portoenterostomy (KP), liver transplantation (LT), and no surgery. Logistic regression with Firth’s method was performed to identify potential influencing variables associated with in-hospital death. RESULTS: During the year 2013 to 2017, there were 14,038 pediatric admissions with a diagnosis of BA. The proportion of in-hospital death in pediatric BA admissions was 1.08%. Compared with patients under six months, there was a higher risk of in-hospital death for children aged six months to 1 year and 1–2 years old. Clinical signs, including cirrhosis, variceal bleeding, and hepatic encephalopathy, were significantly associated with the risk of in-hospital death. In no surgery group, compared to those in Beijing and Shanghai, BA patients admitted in other districts had a lower risk of in-hospital death (OR=0.39, 95% CI: 0.21, 0.70). However, in the LT group, patients admitted in other districts had a higher risk of in-hospital death (OR=9.13, 95% CI: 3.99, 20.87). CONCLUSIONS: In-hospital survival remains unsatisfactory for pediatric BA patients with severe complications. Furthermore, more resources and training for BA treatment, especially LT, are essential for districts with poor medical care in the future. XIA & HE Publishing Inc. 2023-04-28 2022-05-17 /pmc/articles/PMC9817058/ /pubmed/36643040 http://dx.doi.org/10.14218/JCTH.2021.00456 Text en © 2023 Authors. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 4.0 International License (CC BY-NC 4.0), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Shi, Yu Jiang, Yi-Zhou Zhou, Guang-Peng Shi, Ying Gan, Lan-Xia Kong, Yuan-Yuan Wang, Hai-Bo Zhu, Zhi-Jun Sun, Li-Ying Prognostic Factors Related to In-hospital Death in Children with Biliary Atresia: Analysis of a Nationwide Inpatient Database |
title | Prognostic Factors Related to In-hospital Death in Children with Biliary Atresia: Analysis of a Nationwide Inpatient Database |
title_full | Prognostic Factors Related to In-hospital Death in Children with Biliary Atresia: Analysis of a Nationwide Inpatient Database |
title_fullStr | Prognostic Factors Related to In-hospital Death in Children with Biliary Atresia: Analysis of a Nationwide Inpatient Database |
title_full_unstemmed | Prognostic Factors Related to In-hospital Death in Children with Biliary Atresia: Analysis of a Nationwide Inpatient Database |
title_short | Prognostic Factors Related to In-hospital Death in Children with Biliary Atresia: Analysis of a Nationwide Inpatient Database |
title_sort | prognostic factors related to in-hospital death in children with biliary atresia: analysis of a nationwide inpatient database |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9817058/ https://www.ncbi.nlm.nih.gov/pubmed/36643040 http://dx.doi.org/10.14218/JCTH.2021.00456 |
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