Variability in age at Kasai portoenterostomy for biliary atresia across US children's hospitals
jpedsurg.org shows its articles on its own site.
Read the article on jpedsurg.org ↗Article · Mar 2021 · 1 min read
In brief
In brief
Multi-institutional study of 470 infants across 46 US hospitals reveals significant variability in timing of Kasai portoenterostomy for biliary atresia, with median age of 57 days and range from 38 to 76 days. Black/African-American race and Pacific-West region associated with delayed surgery, highlighting potential healthcare disparities in access to timely intervention.
Written by the GCMD Library team from the article.
Abstract
Background/Purpose
The purpose of this study was to assess variability in age at Kasai portoenterostomy (KP) in infants with biliary atresia (BA) across children's hospitals in the United States.
Study Design
A multi-institutional retrospective study was performed examining infants with BA undergoing KP within 6 months of birth from 2016–2019, utilizing the Pediatric Health Information System (PHIS). Multivariable negative binomial mixed effects regression was performed for age at KP, and inter-hospital variability was examined.
Results
Across 46 hospitals, 470 infants with BA underwent KP at a median age of 57 days (IQR 42–72), with 212 (45.1%) undergoing KP at ≥60 days of age. There was significant inter-hospital variability in age at KP ranging from 38 days (95% CI: 31d, 47d) to 76 days (95% CI: 63d, 91d) (p<0.0001). Factors associated with later KP were black or African-American race, urgent/emergent admission, and treatment at a hospital in the Pacific-West region. Predictors of earlier KP included later year, history of neonatal comorbidity, and admission to an intensive care service (all p<0.05).
Conclusion
There is significant variability in the age at KP in infants with BA across children's hospitals in the United States.
Type of Study
Retrospective study. Level of Evidence. III