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Hospital readmission among infants with gastroschisis
A P South1, J J Wessel, A Sberna
1Division of Neonatology, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. andrew.south@cchmc.org
Insights
Hospital readmission is common for infants with gastroschisis, often due to complications like bowel obstruction. Understanding these risks is crucial for parental counseling and care planning.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Gastrointestinal Disorders
Background:
- Infants with gastroschisis experience significant perinatal morbidity, including prematurity and growth restriction.
- Known risk factors for post-natal complications exist, but readmission rates and reasons are not well-documented.
Purpose of the Study:
- To determine the frequency and indications for hospital readmission in infants with gastroschisis after their initial discharge.
Main Methods:
- Retrospective cohort study of surviving infants treated for gastroschisis.
- Data collected from January 2006 to December 2008.
- Analysis included readmission frequency, indications, and associated neonatal risk factors.
Main Results:
- Forty percent (23/58) of infants were readmitted, with 65% occurring in the first year.
- Seventy percent of readmissions were for gastroschisis-related complications, primarily bowel obstruction and abdominal distention/pain.
- Readmission was not associated with gestational age, birth weight, or initial hospitalization length.
Conclusions:
- Hospital readmission is a frequent occurrence for infants with gastroschisis.
- Parental education should address the potential for complications requiring readmission.
- Further research is needed to identify specific determinants of readmission.
Objective:
Infants with gastroschisis have significant perinatal morbidity including long hospitalizations and feeding intolerance. Two thirds are premature and 20% are growth restricted. Despite these known risk factors for post-natal complications, little is known about readmission for infants with gastroschisis. Our objective was to determine the frequency and indication for hospital readmission after initial discharge among infants with gastroschisis.
Study Design:
Retrospective cohort study. All surviving infants treated for gastroschisis at Cincinnati Children's Hospital Medical Center, born between January 2006 and December 2008 were included. Main outcome measures included the frequency and indication for readmission. Associated neonatal risk factors also were assessed.
Result:
Fifty-eight patients were analyzed. Twenty-three (40%) subjects were readmitted (five with multiple readmissions); 65% of readmissions occurred in the first year and 70% involved complications directly related to gastroschisis. The most common reasons for readmission were bowel obstruction and abdominal distention/pain. Median time to readmission directly related to gastroschisis was 23 weeks (range 5 to 92). All three infants with home parenteral nutrition were readmitted. Readmission was not associated with gestational age, birth weight or length of initial hospitalization.
Conclusion:
Readmission after initial hospitalization is common in gastroschisis patients. Parental counseling should include education regarding the possibility of complications requiring readmission. Determinants of readmission require further study.
