Your browser doesn't support javascript.
loading
Factors Associated with Timing and Adverse Outcomes in Patients with Biliary Atresia Undergoing Kasai Hepatoportoenterostomy.
Townsend, Michael Ross; Jaber, Adeeb; Abi Nader, Hanina; Eid, Shaker M; Schwarz, Kathleen.
Afiliación
  • Townsend MR; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: mtownse9@jhmi.edu.
  • Jaber A; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Abi Nader H; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Eid SM; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
  • Schwarz K; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.
J Pediatr ; 199: 237-242.e2, 2018 08.
Article en En | MEDLINE | ID: mdl-29773306
OBJECTIVE: To assess factors associated with timing of hepatoportoenterostomy (HPE) and adverse perioperative outcomes in patients with biliary atresia in the US. STUDY DESIGN: We examined hospitalizations in infants aged <1 year using the National Inpatient Sample database for 2000-2011. We identified cases using the International Classification of Diseases, Ninth Revision, Clinical Modification codes for biliary atresia and HPE. Multivariable logistic regression models were used to examine association between select factors and age at HPE, as well as adverse perioperative outcomes. RESULTS: Our analysis of 1243 biliary atresia hospitalizations showed that only 37.7% of patients had HPE in the first 60 days of life. Patients who underwent HPE after 60 days of age were uninsured, were more likely to be black (aOR, 4.22; 95% CI, 1.49-11.95), less likely to be admitted at a teaching hospital (aOR, 0.27; 95% CI 0.10-0.79), and less likely to have a concomitant congenital malformation (aOR, 0.49; 95% CI 0.25-0.98). Patients with delayed age at HPE incurred significantly higher hospital costs ($57 914 vs $34 074; P = .026). Delayed age at HPE and weekend admission were independently associated with increased odds of adverse perioperative outcome (aOR, 1.09; 95% CI, 1.01-3.02 and 3.98; 95% CI, 1.67-9.46, respectively). CONCLUSION: Current outcomes in patients with biliary atresia in the United States are suboptimal and result in higher costs. The specific factors associated with delayed care are further evidence that universal health care and screening are needed for all infants, along with systematic referral of potential patients with biliary atresia to specialized health centers.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Atresia Biliar / Portoenterostomía Hepática Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Infant / Male Idioma: En Revista: J Pediatr Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Atresia Biliar / Portoenterostomía Hepática Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Infant / Male Idioma: En Revista: J Pediatr Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos