Observational studyMedicine2016
Infant Stool Color Card Screening Helps Reduce the Hospitalization Rate and Mortality of Biliary Atresia: A 14-Year Nationwide Cohort Study in Taiwan.
Observational study in Medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 17 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed.
- Advancing precision hepatology for rare paediatric liver diseases.European journal of pediatrics · 2026Review
- A strategy to identify biliary atresia efficiently: A perspective from a Texas center.World journal of pediatric surgery · 2026Review
- European strategies in the screening of biliary atresia: a scoping review.World journal of pediatric surgery · 2025Review
- Long non-coding RNA growth arrest-specific 5 inhibits liver fibrogenesis in biliary atresia by interacting with microRNA-222 and repressing IGF1/AKT signaling.Translational pediatrics · 2023Article
- A preliminary study of further attempt at the development, testing and application of an independent primary screening stool card.Scientific reports · 2022Article
- [Overview of Biliary Atresia].Journal of the Korean Society of Radiology · 2022Review
- Biliary Atresia Screening in India-Strategies and Challenges in Implementation.Indian journal of pediatrics · 2022Article
- Diagnostic Tools for Early Detection of Biliary Atresia: Is a Newborn Screen Attainable?Clinical liver disease · 2022Review
- Development of integrated neonatal cholestasis card for early recognition and referral of neonatal cholestasis.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2020Article
- Investigation into multi-centre diagnosis and treatment strategies of biliary atresia in mainland China.Pediatric surgery international · 2020Article
- Design and validation of a noninvasive diagnostic criteria for biliary atresia in infants based on the STROBE compliant.Medicine · 2019Observational
- Biliary Atresia: Clinical and Research Challenges for the Twenty-First Century.Hepatology (Baltimore, Md.) · 2018Review
- Newborn screening for biliary atresia in the United States.Pediatric surgery international · 2017Review
- Referral Patterns and Factors Influencing Age at Admission of Infants with Cholestasis in India.Indian journal of pediatrics · 2017Article
- Downregulation of microRNA-145 may contribute to liver fibrosis in biliary atresia by targeting ADD3.PloS one · 2017Article
- Article
- Biliary Atresia: advances and challenges in early diagnosis and management.Jornal de pediatriaReview
Corrections and comments
- Erratum issued
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Biliary atresia (BA) is a significant liver disease in children. Since 2004, Taiwan has implemented a national screening program that uses an infant stool color card (SCC) for the early detection of BA. The purpose of this study was to examine the outcomes of BA cases before and after the launch of this screening program. The objectives of this study were to evaluate the rates of hospitalization, liver transplantation (LT), and mortality of BA cases before and after the program, and to examine the association between the hospitalization rate and survival outcomes.This was a population-based cohort study. BA cases born during 1997 to 2010 were identified from the Taiwan National Health Insurance Research Database. Sex, birth date, hospitalization date, LT, and death data were collected and analyzed. The hospitalization rate by 2 years of age (Hosp/2yr) was calculated to evaluate its association with the outcomes of LT or death.Among 513 total BA cases, 457 (89%) underwent the Kasai procedure. Of these, the Hosp/2yr was significantly reduced from 6.0 to 6.9/case in the earlier cohort (1997-2004) to 4.9 to 5.3/case in the later cohort (2005-2010). This hospitalization rate reduction was followed by a reduction in mortality from 26.2% to 15.9% after 2006. The Cox proportional hazards model showed a significant increase in the risk for both LT (hazard ratio [HR] = 1.14, 95% confidence interval [CI] = 1.10-1.18) and death (HR = 1.05, 95% CI = 1.01-1.08) for each additional hospitalization. A multivariate logistic regression model found that cases with a Hosp/2yr >6 times had a significantly higher risk for both LT (adjusted odds ratio [aOR] = 4.35, 95% CI = 2.82-6.73) and death (aOR = 1.75, 95% CI = 1.17-2.62).The hospitalization and mortality rates of BA cases in Taiwan were significantly and coincidentally reduced after the launch of the SCC screening program. There was a significant association between the hospitalization rate and final outcomes of LT or death. The SCC screening program can help reduce the hospitalization rate and mortality of BA cases and bring great financial benefit.
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