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Survival of newborns with abdominal holes differs according to hospital, Hopkins research shows
October 29, 2007A newborn's chance for surviving a low-risk version of a condition called gastroschisis varies greatly by hospital, according to a study by Johns Hopkins surgeons. Babies with the condition have a hole in their abdomen near the umbilical cord. The uncomplicated variant of the condition, where the hole is the only abdominal anomaly, is fairly easy to repair, and 97 percent of babies survive it. However the Hopkins findings suggest that in some hospitals, far fewer babies who should survive the condition after treatment actually do. Some hospitals had death rates three to five times the national average.
The findings of the study are being presented at the American Academy of Pediatrics Conference Oct. 26 through Oct. 30 in San Francisco.
Researchers compared mortality rates among 1,775 infants born with uncomplicated gastroschisis in 40 U.S hospitals. Only hospitals that had treated at least 25 newborns with gastroschisis were included. Of the 40 hospitals, one-fourth (10) had death rates higher than 2.9 percent, which is the national average for the low-risk variant of the condition. Of the 10, two hospitals had very poor death rates-8.6 percent and 14.3 percent.
"We went into this prepared to see some differences, but we didn't expect to see these striking variations from hospital to hospital in these fairly uncomplicated cases," says investigator Meghan Arnold, M.D., a surgical resident at the Johns Hopkins Children's Center.
Because surgical techniques to repair gastroschisis are uniform across hospitals, researchers say the next step should be finding whether the difference in survival could be due to factors such as different nurse-to-patient ratios, variations in medication and nursing protocols and the availability of pediatric subspecialists.
Johns Hopkins Medical Institutions
"We went into this prepared to see some differences, but we didn't expect to see these striking variations from hospital to hospital in these fairly uncomplicated cases," says investigator Meghan Arnold, M.D., a surgical resident at the Johns Hopkins Children's Center.
Because surgical techniques to repair gastroschisis are uniform across hospitals, researchers say the next step should be finding whether the difference in survival could be due to factors such as different nurse-to-patient ratios, variations in medication and nursing protocols and the availability of pediatric subspecialists.
Johns Hopkins Medical Institutions
Sexually transmitted disease, urinary tract infections may be bad combination for birth defect Chances of gastroschisis increase fourf
Women who reported having both a sexually transmitted disease (STD) and urinary tract infection (UTI) just before or during early pregnancy were four times more likely to have babies with gastroschisis-a severe birth defect in which infants are born with their intestines and other internal organs outside the abdomen, University of Utah researchers report in the online British Medical Journal.
The right kind of oil
Children who cannot eat on their own because of intestinal failure must rely on parenteral nutrition (PN), an intravenous method of feeding.
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