Evidence map›Paper›PMID 36030602›Full record

ArticleThe Journal of surgical research2022

Factors Associated With Gastrostomy Tube Complications in Infants With Congenital Heart Disease.

Nhu N Tran, Elaa M Mahdi, Shadassa Ourshalimian, Stephanie Sanborn, Maria Theresa Alquiros, Paige Kingston, Danny Lascano, Cynthia Herrington, Jodie K Votava-Smith, Lorraine I Kelley-Quon

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of surgical research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Nhu N TranFetal and Neonatal Institute, Division of Neonatology, Children's Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine of the University of Southern California, Los Angeles, California. Electronic address: ntran@chla.usc.edu.
Elaa M MahdiDivision of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California.
Shadassa OurshalimianDivision of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California.
Stephanie SanbornClinical Nutrition and Lactation Services, Children's Hospital Los Angeles, Los Angeles, California.
Maria Theresa AlquirosDivision of Cardiothoracic Surgery, Children's Hospital Los Angeles, Los Angeles, CA Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California.
Paige KingstonDivision of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California.
Danny LascanoDivision of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California.
Cynthia HerringtonDivision of Cardiothoracic Surgery, Children's Hospital Los Angeles, Los Angeles, CA Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California.
Jodie K Votava-SmithDivision of Cardiology, Children's Hospital Los Angeles and Keck School of Medicine, University of Southern California, Los Angeles, California.
Lorraine I Kelley-QuonDivision of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California; Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California.
Children's Hospital of Los Angeles · USUniversity of Southern California · US

Funding

Southern California Clinical and Translational Science InstituteUL1TR001855 · NCATS · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Thomas A Buchanan, Michele D. Kipke · 2016 to 2026
$81.3M
NCATS NIH HHS UL1 TR001855
6 · The paper itself

Abstract

introductionChildren with congenital heart disease (CHD) often experience feeding intolerance due to aspiration, inability to tolerate feed volume, or reflux within the first few months of life, requiring a surgically placed gastrostomy tube (GT) for durable enteral access. However, complications such as GT dislodgement, cellulitis, and leakage related to GT use are common. GT-related complications can lead to unscheduled pediatric surgery clinic or emergency room (ER) visits, which can be time consuming for the family and increase overall healthcare costs. We sought to identify factors associated with GT complications within 2 wk after GT surgery and 1-y after discharge home following GT placement in infants with CHD.

methodsWe performed a retrospective cohort study using the Society of Thoracic Surgeons database and electronic medical records from a tertiary children's hospital. We identified infants <1 y old underwent CHD surgery followed by GT surgery between September 2013-August 2018. Demographics, pre-operative feeding regimen, comorbidities, and GT-related utilization were measured. Postoperative GT complications (e.g., GT cellulitis, leakage, dislodgement, obstruction, and granulation tissue) within 2 wk after the GT surgery and an unplanned pediatric surgery clinic or ER visit within 1-y after discharge home were captured. Bivariate comparisons and multivariable logistic regression evaluated factors associated with GT complications and unplanned clinic or ER visits. A Kaplan-Meier failure curve examined the timing of ER/clinic visits.

resultsOf 152 infants who underwent CHD then GT surgeries, 66% (N = 101) had postoperative GT complications. Overall, 83 unscheduled clinic visits were identified after discharge, with 37% (N = 31) due to concerns about granulation tissue. Of 137 ER visits, 48% (N = 66) were due to accidental GT dislodgement. Infants who were hospitalized for ≥2 wk after GT surgery had more complications than those discharged home within 2 wk of the GT surgery (40.6% versus 15.7%, P = 0.002). Infants receiving oral nutrition before CHD surgery (38.6% versus 60%, P=<0.001) or with single ventricle defects (19.8% versus 37.3%, P = 0.02) had fewer GT complications. After adjusting for type of cardiac anomaly, infants receiving oral nutrition prior to CHD surgery had a decreased likelihood of GT complications (odds ratio OR 0.46; 95% confidence intervals CI:0.23-0.93). A Kaplan-Meier failure curve demonstrated that 50% of the cohort experienced a complication leading to an unscheduled ER/clinic visit within 6 mo after discharge.

conclusionsUnplanned visits to the ER or pediatric surgery clinic occur frequently for infants with CHD requiring a surgically placed GT. Oral feedings before cardiac surgery associated with fewer GT complications. Prolonged hospitalization associated with more GT complications. Optimizing outpatient care and family education regarding GT maintenance may reduce unscheduled visits for this high-risk, device-dependent infant population.

Indexed as

GastrostomyHeart Defects, CongenitalCellulitisChildHumansInfantInfant, NewbornIntubation, GastrointestinalPostoperative ComplicationsRetrospective StudiesComplicationsCongenital heart diseaseGastrostomy tubeInfants

Identifiers

PMID36030602
PMCPMC10231870
OpenAlexW4293679155

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.