TY - JOUR
T1 - Canadian Pediatric Surgical Network
T2 - a population-based pediatric surgery network and database for analyzing surgical birth defects. The first 100 cases of gastroschisis
AU - Skarsgard, Erik D.
AU - Claydon, Jennifer
AU - Bouchard, Sarah
AU - Kim, Peter C.W.
AU - Lee, Shoo K.
AU - Laberge, Jean Martin
AU - McMillan, Douglas
AU - von Dadelszen, Peter
AU - Yanchar, Natalie
PY - 2008/1
Y1 - 2008/1
N2 - Purpose: Outcomes studies for gastroschisis are constrained by small numbers, prolonged accrual, and nonstandardized data collection. The aim of this study is to create a national pediatric surgical network and database for gastroschisis (GS) that tracks cases from diagnosis to hospital discharge. Methods: The 16-center network serves a population of 32 million. Gastroschisis cases are ascertained at prenatal diagnosis. Perinatal data include maternal risk and fetal ultrasound variables, delivery plan and outcome, a postnatal bowel injury score, intended and actual surgical treatment, and neonatal outcomes. Institutional review board-approved data collection conforms to regional privacy legislation. Deidentified data are centralized and accessible for research through the network steering committee. Results: To date, 114 cases of pre- and/or postnatal gastroschisis have been uploaded. Of 106 live-born infants (40 [38%] by cesarean delivery), 100 had complete records, and overall survival to discharge was 96%, with a mean survivor length of stay (LOS) of 46 days. Infants treated with attempted urgent closure (61%) had significantly shorter LOS (42 vs 57days; P = .048) but comparable LOS compared with those treated with silos and delayed closure. Fetal bowel dilation 18 mm or greater did not predict a difference in outcome. Conclusion: Population-based databases allow rapid case accrual and enable studies that should aid in the identification of optimal perinatal treatment.
AB - Purpose: Outcomes studies for gastroschisis are constrained by small numbers, prolonged accrual, and nonstandardized data collection. The aim of this study is to create a national pediatric surgical network and database for gastroschisis (GS) that tracks cases from diagnosis to hospital discharge. Methods: The 16-center network serves a population of 32 million. Gastroschisis cases are ascertained at prenatal diagnosis. Perinatal data include maternal risk and fetal ultrasound variables, delivery plan and outcome, a postnatal bowel injury score, intended and actual surgical treatment, and neonatal outcomes. Institutional review board-approved data collection conforms to regional privacy legislation. Deidentified data are centralized and accessible for research through the network steering committee. Results: To date, 114 cases of pre- and/or postnatal gastroschisis have been uploaded. Of 106 live-born infants (40 [38%] by cesarean delivery), 100 had complete records, and overall survival to discharge was 96%, with a mean survivor length of stay (LOS) of 46 days. Infants treated with attempted urgent closure (61%) had significantly shorter LOS (42 vs 57days; P = .048) but comparable LOS compared with those treated with silos and delayed closure. Fetal bowel dilation 18 mm or greater did not predict a difference in outcome. Conclusion: Population-based databases allow rapid case accrual and enable studies that should aid in the identification of optimal perinatal treatment.
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U2 - 10.1016/j.jpedsurg.2007.09.011
DO - 10.1016/j.jpedsurg.2007.09.011
M3 - Article
C2 - 18206451
AN - SCOPUS:38149059633
SN - 0022-3468
VL - 43
SP - 30
EP - 34
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 1
ER -