Age and weight stratified outcomes of single stage endorectal pull-through procedures for hirschsprung's disease in children: Analysis of NSQIP-P data
Document Type
Article
Department
Surgery; Paediatric Surgery
Abstract
Background: We aimed to analyze the effect of age and weight on 30-day outcomes of single-stage endorectal pull tthrough (ERPT) procedures for Hirschsprung's Disease (HD) using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database to identify an optimal time for surgery.
Methods: We queried NSQIP-P for children <2 years with HD who underwent ERPT between 2016-2021 and did not have a preoperative stoma. Patients were stratified by age (<3 months, 3-6 months and >6 months) and weight (<4 kg, 4-8 kg, and >8 kg) at the time of surgery. The primary outcome measure was major adverse outcomes, and the secondary outcomes were 30-day unplanned readmission and reoperation. Multivariable logistic regression was conducted to analyze the association between age and weight and each outcome.
Results: A total of 1002 patients were included with a median age of 31 days (IQR: 10-106 days). Patients were stratified by age (n = 702, 70.1 %; n = 158, 15.8 %; n = 142, 14.2 % respectively from youngest to oldest) and weight (n = 472, 47.1 %; n = 421, 42.0 %; n = 109, 10.9 % respectively from lowest to highest weight) groups. On multivariable analysis, age>6 months and weight>8 kg were independently associated with a higher rate of major complications (aOR = 2.741, 95 % C.I. = 1.234-5.880 and aOR = 4.627, 95 % C.I. = 1.761-11.775 respectively). Conversely, being in the highest age (aOR = 0.359, 95 % C.I. = 0.176-0.699) and weight brackets (aOR = 0.396, 95 % C.I. = 0.171-0.801) independently predicted lower 30-day readmission rates.
Conclusion: Earlier single-stage ERPT for HD was found to be associated with lower complication rates in a select group of patients but may result in increased rates of readmissions and hospital resource utilization.
Publication (Name of Journal)
Journal of Pediatric Surgery
DOI
10.1016/j.jpedsurg.2025.162168
Recommended Citation
Thobani, H.,
Tahan, D.,
Shah, A. A.,
aymond, S. L.,
Chiu, B.,
Islam, S.,
Khan, F. A.
(2025). Age and weight stratified outcomes of single stage endorectal pull-through procedures for hirschsprung's disease in children: Analysis of NSQIP-P data. Journal of Pediatric Surgery, 1-6.
Available at:
https://ecommons.aku.edu/pakistan_fhs_mc_surg_paediatr/206
Comments
Volume and issue number is not provided by the author/publisher.