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The association of perinatal and clinical factors with outcomes in infants with gastroschisis—a retrospective multicenter study in Finland

Authors
  • Tauriainen, Asta1
  • Sankilampi, Ulla2
  • Raitio, Arimatias3
  • Tauriainen, Tuomas4
  • Helenius, Ilkka5
  • Vanamo, Kari1
  • Hyvärinen, Anna6
  • 1 University of Eastern Finland and Kuopio University Hospital,
  • 2 Kuopio University Hospital,
  • 3 University of Turku and Turku University Hospital,
  • 4 Oulu University Hospital,
  • 5 University of Helsinki and Helsinki University Hospital,
  • 6 University of Tampere and Tampere University Hospital,
Type
Published Article
Journal
European Journal of Pediatrics
Publisher
Springer-Verlag
Publication Date
Feb 02, 2021
Volume
180
Issue
6
Pages
1875–1883
Identifiers
DOI: 10.1007/s00431-021-03964-w
PMID: 33532890
PMCID: PMC7853702
Source
PubMed Central
Keywords
Disciplines
  • Original Article
License
Unknown

Abstract

The aim of the present study was to assess the prognostic factors for the outcome of gastroschisis in Finland. A retrospective multicenter study of gastroschisis patients born between 1993 and 2015 in four Finnish university hospitals was undertaken, collecting perinatal, surgical, and clinical data of neonates for uni- and multifactorial modeling analysis. The aim of the present study was to identify risk factors for mortality and the composite adverse outcome (death and/or short bowel syndrome or hospital stay > 60 days). Of the 154 infants with gastroschisis, the overall survival rate was 90.9%. In Cox regression analysis, independent risk factors for mortality included liver herniation, pulmonary hypoplasia, relaparotomy for perforation or necrosis, abdominal compartment syndrome, and central line sepsis. Furthermore, a logistic regression analysis identified central line sepsis, abdominal compartment syndrome, complex gastroschisis, and a younger gestational age as independent predictors of the composite adverse outcome. Conclusion : The risk of death is increased in newborns with gastroschisis who have liver herniation, pulmonary hypoplasia, abdominal compartment syndrome, relaparotomy for perforation or necrosis, or central line–associated sepsis. Special care should be taken to minimize the risk of central line sepsis in the clinical setting. What is known: • Gastroschisis is a relatively rare congenital anomaly of the abdominal wall and its incidence is increasing .• Complex gastroschisis has been reported to increase risk of mortality and complications . What is new: • Central line sepsis was found to be independently associated with mortality in gastroschisis patients .• Liver herniation was also significantly associated with mortality .

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