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The Prognostic Impact of Defect Size Based on Body Surface Area in Omphaloceles
Bade Toker Kurtmen1, Dilnur Sevinc1, Emine Burcu Cigsar Kuzu1
1Department of Pediatric Surgery, University of Health Sciences, Tepecik Education and Research Hospital, Izmir, Turkey.
Insights
The omphalocele diameter-to-body surface area (BSA) ratio is a strong predictor of mortality in neonates. This ratio offers superior prognostic value compared to other omphalocele markers.
Area of Science:
- Neonatal surgery
- Pediatric surgery
- Medical diagnostics
Background:
- Omphalocele is a congenital abdominal wall defect with variable outcomes.
- Understanding prognostic factors is crucial for managing omphalocele cases, especially in premature and low birth weight neonates.
- Existing research has gaps in identifying reliable prognostic indicators for omphalocele.
Purpose of the Study:
- To investigate the prognostic impact of the omphalocele diameter-to-body surface area (BSA) ratio.
- To compare the prognostic value of this ratio against traditional markers in omphalocele patients.
- To identify mortality-associated factors in neonates with omphalocele.
Main Methods:
- Retrospective analysis of 25 omphalocele patient records.
- Calculation of BSA using the Haycock Formula.
- Binary logistic regression analysis to determine mortality predictors.
Main Results:
- The defect diameter-to-BSA ratio was significantly higher in non-survivors (467.9) compared to survivors (283.1).
- Logistic regression identified the defect diameter-to-BSA ratio as a significant predictor of mortality (p=0.023).
- Defect size, cardiac anomalies, and presence of solid organs were not significant mortality predictors.
Conclusions:
- The defect diameter-to-BSA ratio demonstrates superior prognostic value for omphalocele patients.
- This ratio surpasses conventional markers like defect diameter and presence of solid organs in predicting outcomes.
- The findings highlight a novel, effective tool for assessing omphalocele prognosis.
Introduction:
This study addresses the existing gaps in understanding the cases with omphalocele by investigating the potential prognostic impact of the ratio between omphalocele diameter-and -body surface area (BSA), particularly in premature and low birth weight neonates.
Material And Methods:
Data retrieved from the hospital files of 25 patients with omphalocele related to their gestational histories, demographics, anthropometric data, comorbidities, defect diameters, and prognoses were retrospectively analyzed. BSA was calculated using the Haycock Formula. Binary logistic regression analysis performed identified mortality-associated factors.
Results:
Most (84 %) of the patients with omphalocele, required mechanical ventilation, and the median hospital stay was 19 days. There was no significant correlation between defect diameter or defect diameter-to-BSA ratio and hospital stay. Mortality rate in these patients was 24 %, with a significantly higher mean (±SD) defect diameter-to-BSA ratio in non-survivors compared to survivors (467.9 ± 54.8 vs. 283.1 ± 24.8; p = 0.002). Logistic regression analysis identified the defect diameter-to-BSA ratio as a significant predictor of mortality (p = 0.023, Exp(B) = 1.038, 95 % CI: 1.005-1.072). Other variables, including defect size, cardiac anomalies, and solid organ presence in the sac, were not significant predictors.
Conclusion:
This study underscores the superior prognostic value of the defect diameter-to-BSA ratio for omphalocele patients, surpassing conventional markers such as defect diameter, cardiac anomalies, and the presence of solid organs in the sac.
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