Clinical features and practice patterns of gastroschisis: a retrospective analysis using a Japanese national inpatient database

Pediatr Surg Int. 2018 Jul;34(7):727-733. doi: 10.1007/s00383-018-4277-6. Epub 2018 May 16.

Abstract

Purpose: The number of infants with gastroschisis is increasing worldwide, but advances in neonatal intensive care and parenteral nutrition have reduced gastroschisis mortality. Recent clinical data on gastroschisis are often from Western nations. This study aimed to examine clinical features and practice patterns of gastroschisis in Japan.

Methods: We examined treatment options, outcomes, and discharge status among inpatients with simple gastroschisis (SG) and complex gastroschisis (CG), 2010-2016, using a national inpatient database in Japan.

Results: The 247 eligible patients (222 with SG) had average birth weight of 2102 g and average gestational age of 34 weeks; 30% had other congenital anomalies. Digestive anomalies were most common, followed by circulatory anomalies. In-hospital mortality was 8.1%. The median age at start of full enteral feeding was 30 days. The median length of stay was 46 days. There were no significant differences in outcomes except for length of stay, starting full enteral feeding and total hospitalization costs between the SG and CG groups. About 80% of patients were discharged to home without home medical care. The readmission rate was 28%.

Conclusion: This study's findings on the clinical characteristics and outcomes of gastroschisis are useful for the clinical management of gastroschisis.

Keywords: Abdominal wall defect; Complex gastroschisis; Gastroschisis; Neonatal; Pediatric surgery.

MeSH terms

  • Abnormalities, Multiple / epidemiology
  • Birth Weight
  • Databases, Factual
  • Enteral Nutrition
  • Female
  • Gastroschisis / epidemiology*
  • Gastroschisis / therapy*
  • Gestational Age
  • Hospital Mortality
  • Humans
  • Infant, Newborn
  • Japan / epidemiology
  • Length of Stay / statistics & numerical data
  • Male
  • Patient Readmission / statistics & numerical data
  • Retrospective Studies