title: Steroid use after the Kasai procedure for biliary atresia.
abstract: BACKGROUND
  The aim of this study was to describe patients undergoing the Kasai procedure at children's hospitals, evaluate outcomes, and analyze the association of these outcomes with systemic steroid use.
  
  
  METHODS
  Biliary atresia patients (International Classification of Diseases, Ninth Revision, code 751.61) who underwent Kasai procedures at freestanding children's hospitals in the Pediatric Health Information System database from 2003 to 2008 were identified. Descriptive characteristics were examined, and regression analyses were used to determine whether postoperative steroid use was associated with length of stay, mortality, or cholangitis.
  
  
  RESULTS
  Of the 516 children identified (40% male, 50% aged < 2 months), 239 (46%) received perioperative steroids. The mean total and postoperative lengths of stay were 14.5 +/- 19.7 and 11.3 +/- 16.3 days, respectively. Postoperative steroid use was significantly associated with a 3.5-day decrease in postoperative length of stay (95% confidence interval, .03-6.97).
  
  
  CONCLUSIONS
  Perioperative steroids after the Kasai procedure are associated with shorter postoperative length of stay. Work is needed to ascertain whether this relationship is causal.
authors.affiliation: Department of Surgery, Seattle Children's Hospital, Seattle, WA, USA. olao@uw.edu
authors.forename: Oliver B
authors.initials: OB
authors.lastname: Lao
authors.forename: Cindy
authors.initials: C
authors.lastname: Larison
authors.forename: Michelle
authors.initials: M
authors.lastname: Garrison
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Healey
authors.forename: Adam B
authors.initials: AB
authors.lastname: Goldin
mesh_terms: D001656:Biliary Atresia / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D015331:Cohort Studies; D016001:Confidence Intervals; D016208:Databases, Factual; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D011171:Portoenterostomy, Hepatic / Q000009:adverse effects / Q000379:methods*; D011182:Postoperative Care / Q000379:methods; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013256:Steroids / Q000627:therapeutic use*; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D013256:Steroids
references.citation: J Pediatr. 2006 Apr;148(4):467-474
references.pmid: 16647406
references.citation: Am J Gastroenterol. 2008 Mar;103(3):712-9
references.pmid: 18177447
references.citation: J Pediatr Surg. 2001 Jan;36(1):80-5
references.pmid: 11150442
references.citation: J Pediatr Surg. 1997 Jul;32(7):1103-6; discussion 1106-7
references.pmid: 9247243
references.citation: Lancet. 1989 Feb 25;1(8635):421-3
references.pmid: 2563796
references.citation: J Pediatr Surg. 2003 Mar;38(3):406-11
references.pmid: 12632357
references.citation: J Pediatr Surg. 2006 Jan;41(1):99-103; discussion 99-103
references.pmid: 16410116
references.citation: Eur J Pediatr Surg. 2007 Jun;17(3):180-3
references.pmid: 17638156
references.citation: Hepatology. 2007 Dec;46(6):1821-7
references.pmid: 17935230
references.citation: J Pediatr Surg. 1985 Dec;20(6):693-5
references.pmid: 4087100
references.citation: Hepatology. 2006 Jul;44(1):75-84
references.pmid: 16799986
references.citation: J Pediatr Surg. 2004 Dec;39(12):1800-2
references.pmid: 15616934
references.citation: J Pediatr Surg. 2003 Apr;38(4):590-3
references.pmid: 12677572
references.citation: Lancet. 2000 Jan 1;355(9197):25-9
references.pmid: 10615887