Michael Helmrath · Outcomes in gastroschisis: expectations in the postnatal period for simple vs complex gastroschisis
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Article1 min read·Published May 2021Older

Outcomes in gastroschisis: expectations in the postnatal period for simple vs complex gastroschisis

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Article · May 2021 · 1 min read

In brief

In brief

Multi-institutional study of 394 gastroschisis patients reveals complex cases (20%) have significantly worse outcomes than simple cases: 3x longer hospital stays (105 vs 33 days), higher infection rates (31% vs 11%), and 11% mortality vs 0%. Data provides evidence-based benchmarks for prenatal counseling and postnatal care planning.

Written by the GCMD Library team from the article.

Michael Helmrath

Objective: To provide generalizable estimates for expected outcomes of simple gastroschisis (SG) and complex gastroschisis (CG) patients from a large multi-institutional cohort for use during counseling. Study Design: A retrospective study of 394 neonates with gastroschisis at 11 children's hospitals from January 2013 to March 2017 was performed. Analysis by Fisher's exact tests and Wilcoxon rank sum tests were performed. Outcomes of complex and simple gastroschisis are reported. Result: There were 315 (80%) SG and 79 (20%) CG. CG had increased time from birth to closure (6 vs 4.4 days), closure to goal feeds (69 vs 23 days), ventilator use (90% vs 73%), SSIs (31% vs 11%), NEC (14% vs 6%), PN use (71 vs 24 days), LOS (104.5 vs 33 days), and mortality (11% vs 0%). Conclusion: This study provides generalizable estimates for expected outcomes of patients with both SG and CG that can be utilized during counseling. CG has significantly worse in-hospital outcomes.

Statements in this article

  1. In this cohort, 80% of gastroschisis cases were simple gastroschisis and 20% were complex gastroschisis.

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  2. Complex gastroschisis had a median time from birth to closure of 6 days compared to 4.4 days for simple gastroschisis.

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  3. Complex gastroschisis had a median time from closure to goal feeds of 69 days compared to 23 days for simple gastroschisis.

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  4. Ventilator use occurred in 90% of complex gastroschisis patients compared to 73% of simple gastroschisis patients.

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  5. Surgical site infections occurred in 31% of complex gastroschisis patients compared to 11% of simple gastroschisis patients.

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  6. Necrotizing enterocolitis occurred in 14% of complex gastroschisis patients compared to 6% of simple gastroschisis patients.

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  7. Complex gastroschisis required a median of 71 days of parenteral nutrition compared to 24 days for simple gastroschisis.

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  8. Complex gastroschisis had a median length of stay of 104.5 days compared to 33 days for simple gastroschisis.

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  9. Mortality was 11% in complex gastroschisis compared to 0% in simple gastroschisis.

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  10. Complex gastroschisis has significantly worse in-hospital outcomes than simple gastroschisis.

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