Inter-Center Variations in Inpatient Outcomes for Infants with Gastroschisis from the Children's Hospitals Neonatal Consortium

Abstract

Objective: To estimate inter-center variation (ICV) in hospital length of stay (LOS) and oral feeding at discharge among infants with gastroschisis. Study Design: Children's Hospitals Neonatal Consortium's (CHNC) database was used to identify hospitalized survivors with gastroschisis. Two outcomes were evaluated: LOS and discharge without tube feedings. Hospital outcomes were evaluated in unadjusted and adjusted analyses. Generalized linear models with log link for gamma distribution was used to model LOS and logistic regression for discharge without tube feeds. Results: For 3987 surviving infants with gastroschisis, LOS and discharge within 70 days with exclusively oral feeding, both exhibited significant ICV. Differences persisted in multivariable analyses. Risk adjusted LOS (68% difference) and oral feeding at discharge (6.4-fold difference) varied significantly between centers. Conclusion: Hospital of care was independently associated with LOS and exclusive oral feeding at discharge rates for infants with gastroschisis. Management differences, potentially influenced by parental preferences, contributed to variation.