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Building the Foundation for Standardized Care Metrics in Jejunoileal Atresia: A Systematic Review of Reported
Linde Margriet van der Kamp1,2,3, Cristina Moglia4, Enrico La Pergola5
1European Reference Network for Rare Inherited and Congenital Anomalies (ERNICA), Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
Abstract:
Background/Objectives: An evidence-based list of key variables regarding jejunoileal atresia (JIA) care needs to be established to enable quality evaluation and optimization of its care. The aim of this study is to provide an overview of reported patient, treatment, and outcome variables for JIA as documented in recent literature. This list has not been developed previously and will be the foundation for a JIA quality indicator set of the European Pediatric Surgery Audit (EPSA). Methods: A systematic review of the literature on the primary care path of JIA, published between 2013 and 2023, was conducted following the PRISMA guidelines. All relevant patient characteristics, parameters regarding JIA treatment, and outcomes were extracted from the included publications. Results: A total of 844 variables were extracted from 94 included articles. One hundred fifty-seven parameters were mentioned in more than 5% of publications. The most mentioned patient characteristics were sex (86%), gestational age (71%), and associated anomalies (66%). The most mentioned treatment parameters were stoma placement (34%), primary anastomosis (41%), and time to full enteral nutrition (24%). Most mentioned outcomes were mortality (70%), length of hospital stay (55%), and complications (60%). Conclusions: This study created an overview of reported patient characteristics, treatment, and outcome variables regarding the treatment of JIA. A focus on the short-term management and outcomes of JIA was observed; frequently discussed topics were perioperative management, surgical techniques, and feeding management. Our results will serve as the foundation for a Delphi study to develop a core indicator set for JIA, enabling benchmarking and measurement of quality of care.
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