Effect of time to surgical evaluation on the outcomes of infants with gastroschisis.
OBJECTIVE
Our goal is to identify the impact of time to surgical intervention on the outcomes of infants with gastroschisis.


METHODS
After institutional review board approval, we performed a retrospective review of the medical records of all infants admitted to our institution from 2001 to 2010. Transport, bowel stabilization, and closure times were defined as the time from birth to admission, admission to the first-documented operative intervention, and first operative intervention to abdominal closure, respectively. Outcomes included age at full enteral feeds, total parental nutrition days, ventilator days, and hospital length of stay. Multivariate analysis was used to identify independent predictors of the outcomes.


RESULTS
One hundred eighteen infants with gastroschisis were included in our study. Transport and bowel stabilization times were not predictive of any outcome. However, the time to abdominal wall closure and postnatal gastrointestinal complications were independently predictive of age at full enteral feeds, total parenteral nutrition days, and hospital length of stay.


CONCLUSIONS
Time to surgical evaluation/bowel stabilization was not predictive of any clinically relevant outcomes in infants with gastroschisis. These data demonstrate that potential benefits from prenatal regionalization of infants with gastroschisis are not supported by decreased time to operative intervention.
Division of Pediatric Surgery, Department of Surgery, St Louis Children's Hospital, Washington University School of Medicine, St Louis, MO 63110, USA. bucherb@wudosis.wustl.edu
Brian T
BT
Bucher
Ioanna G
IG
Mazotas
Brad W
BW
Warner
Jacqueline M
JM
Saito
D000015:Abnormalities, Multiple / Q000453:epidemiology; D004750:Enteral Nutrition / Q000706:statistics & numerical data; D005260:Female; D020139:Gastroschisis / Q000601:surgery*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010289:Parenteral Nutrition, Total / Q000706:statistics & numerical data; D010360:Patient Transfer; D011183:Postoperative Complications / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome