Risk factors for perioperative hypothermia and infectious outcomes in gastroschisis patients. J Pediatr Surg 2021 Jul;56(7):1107-1112
Date
04/19/2021Pubmed ID
33865604DOI
10.1016/j.jpedsurg.2021.03.020Scopus ID
2-s2.0-85104656858 (requires institutional sign-in at Scopus site) 6 CitationsAbstract
INTRODUCTION: Prior data suggest that infants with gastroschisis are at high risk for hypothermia and infectious complications (ICs). This study evaluated the associations between perioperative hypothermia (PH) and ICs in gastroschisis using a multi-institutional cohort.
METHODS: Retrospective review of infants with gastroschisis who underwent abdominal closure from 2013-2017 was performed at 7 children's hospitals. Any-IC and surgical site infection (SSI) were stratified against the presence or absence of PH, and perioperative characteristics associated with PH and SSI were determined using multivariable logistic regression.
RESULTS: Of 256 gastroschisis neonates, 42% developed PH, with 18% classified as mild hypothermia (35.5-35.9 °C), 10.5% as moderate (35.0-35.4 °C), and 13% severe (<35 °C). There were 82 (32%) ICs with 50 (19.5%) being SSIs. No associations between PH and any-IC (p = 0.7) or SSI (p = 0.98) were found. Pulmonary comorbidities (odds ratio (OR)=3.76, 95%CI:1.42-10, p = 0.008) and primary closure (OR=0.21, 95%CI:0.12-0.39, p<0.001) were associated with PH, while silo placement (OR=2.62, 95%CI:1.1-6.3, p = 0.03) and prosthetic patch (OR=3.42, 95%CI:1.4-8.3, p = 0.007) were associated with SSI on multivariable logistic regression.
CONCLUSIONS: Primary abdominal closure and pulmonary comorbidities are associated with PH in gastroschisis, however PH was not associated with increased risk of ICs. Independent risk factors for SSI include silo placement and prosthetic patch closure.
Author List
Bence CM, Landisch RM, Wu R, Szabo A, McElhinney K, Austin MT, Fraser JD, St Peter SD, Joshi S, Lillegard JB, Tay S, Warner BW, Kim AG, Perrone EE, Leys CM, Kohler JE, Wagner AJAuthors
Christina Bence MD Assistant Professor in the Surgery department at Medical College of WisconsinAniko Szabo PhD Professor in the Data Science Institute department at Medical College of Wisconsin
Amy Wagner MD Professor in the Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
ChildGastroschisis
Humans
Hypothermia
Infant
Infant, Newborn
Retrospective Studies
Risk Factors
Surgical Wound Infection
Treatment Outcome