Factors Associated To Postoperative Complications on Patients With Gastroschisis in Two Institutions of A Middle-Income Country In Cali, Colombia, Between 2018 And 2022.
Abstract
Introduction: Gastroschisis is a surgical pathology whose worldwide incidence has increased in recent decades, in which postoperative complications (POC) represent significant morbidity and are associated with higher mortality.
Objective: To identify factors associated with POC in newborns with gastroschisis in two institutions in Cali, Colombia during the years 2018-2022.
Methodology: Observational, retrospective and analytical study of newborns diagnosed with gastroschisis admitted to two intensive care units during a four-year period. Medical records were reviewed. Quantitative variables were analyzed and measures of central tendency and dispersion were calculated. Qualitative and categorical variables were organized into frequency and percentage distributions. A logistic regression model was used to explore possible associations between the covariates and the variable of interest. A statistical significance of 5% was applied.
Results:56 babies were included, birth rate was 1/1,000 live births. 25% had complex gastroschisis. 57.1% underwent first surgical intervention < 3 hours after birth, 37.5% achieved primary closure, and of those requiring delayed closure, 68.6% had a prosthetic silo. 23.3% patients had POC, 21.4% died.
Failure to achieve full enteral feedings increased the probability of POC by 6.51 times, other factors associated with POC were achieving closure after 5 days of life, prolonged invasive mechanical ventilation and prolonged hospital stay. Patients with POC had a probability of dying 5.29 times higher than those without.
Conclusions: This study shows a significant frequency of POC in babies with gastroschisis associated with clinical and surgical factors, which must be identified in the search for the best interventions that improve the prognosis and reduce mortality in low- and middle-income countries.
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