Hirschsprung-associated enterocolitis in children treated at US children's hospitals
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In brief
In brief
Multi-center study of 2,030 children with Hirschsprung disease found 7% experienced recurrent enterocolitis after pull-through surgery, with hospital rates varying from 0-33%. Pre-operative HAEC, CNS infection history, and neurologic anomalies increased recurrence risk, which was strongly associated with need for reoperation.
Written by the GCMD Library team from the article.
Background
The incidence of and risk factors for Hirschsprung's-associated enterocolitis (HAEC) following pull-through have been limited to single institutions studies. We characterized the incidence of, risk factors for, and consequences of post-operative HAEC.
Methods
We identified children with Hirschsprung's Disease (HD) at US Children's Hospitals from 2007 to 2017 with and an associated pull-through operation at less than 1 year of age. HAEC readmissions were identified using ICD9/10 Diagnosis Codes and antibiotic administration. Hierarchical logistic regression models were developed for the risk factors for HAEC after pull-through and effects of recurrent HAEC on HD-related reoperations.
Results
We identified 2030 children with HD, and 138 (7%) who had two or more readmissions related to HAEC. The frequency of recurrent HAEC by hospital ranged from 0 to 33%. Pre-operative HAEC, history of central nervous system infection, and congenital neurologic anomalies were associated with increased risk of recurrent HAEC. Recurrent HAEC was associated with HD-specific re-operation (OR 5.2, CI 3.3–8.1, p