Journal of pediatric surgery · 2010
Outcomes in children with intestinal failure following listing for intestinal transplant.
Сравнительное исследованиеСтатьяResearch Support, American Recovery and Reinvestment ActПоддержка службы здравоохранения СШАНазвание и аннотация: Перевод в очереди
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Lao Oliver B, Healey Patrick J, Perkins James D, Reyes Jorge D, Goldin Adam B
Аннотация
PURPOSE: The purpose of this study was to describe the population of pediatric patients waiting for intestinal transplant and to evaluate the risk of death or transplant by specific disease states.
METHODS: We studied the United Network for Organ Sharing (UNOS) database (Jan 1,1991 to 5/16/08) for patients 21 years old or younger at first listing for intestinal transplant and examined their age, sex, weight, and diagnoses. Time to list removal was summarized with cumulative incidence curves. Multinomial logistic regression was used to compare relative risk ratios for removal from the list for transplant, death, or other reasons.
RESULTS: We identified 1712 children listed for intestinal transplant (57% male, 51% <1 year, weight 8.1 kg [IQR, 6.1-14.1] at listing). Median age and weight at transplant (n = 852) were 1 year (IQR, 1-5) and 10 kg (IQR, 6.5-16.3). Regression analysis demonstrated significant differences in outcomes among disease conditions (P < .001). Compared to the gastroschisis group, the relative risk ratio for death versus transplant was higher in the necrotizing enterocolitis group (P = .015), lower in the short gut syndrome group (P = .001), and not different in the volvulus group (P = .94) after adjustment for weight and sex.
CONCLUSIONS: We conclude that the relative risk of transplant vs death varies significantly by the disease condition of the patient.
METHODS: We studied the United Network for Organ Sharing (UNOS) database (Jan 1,1991 to 5/16/08) for patients 21 years old or younger at first listing for intestinal transplant and examined their age, sex, weight, and diagnoses. Time to list removal was summarized with cumulative incidence curves. Multinomial logistic regression was used to compare relative risk ratios for removal from the list for transplant, death, or other reasons.
RESULTS: We identified 1712 children listed for intestinal transplant (57% male, 51% <1 year, weight 8.1 kg [IQR, 6.1-14.1] at listing). Median age and weight at transplant (n = 852) were 1 year (IQR, 1-5) and 10 kg (IQR, 6.5-16.3). Regression analysis demonstrated significant differences in outcomes among disease conditions (P < .001). Compared to the gastroschisis group, the relative risk ratio for death versus transplant was higher in the necrotizing enterocolitis group (P = .015), lower in the short gut syndrome group (P = .001), and not different in the volvulus group (P = .94) after adjustment for weight and sex.
CONCLUSIONS: We conclude that the relative risk of transplant vs death varies significantly by the disease condition of the patient.
Предметные рубрики MeSH
Age FactorsCause of DeathChild, PreschoolDatabases, FactualEnterocolitis, NecrotizingFemaleGastroschisisHealth Care RationingHumansIncidenceInfantIntestinal VolvulusIntestinesLogistic ModelsMaleOutcome Assessment, Health CarePatient SelectionRiskSex FactorsShort Bowel SyndromeTissue and Organ ProcurementTransplantationUnited StatesWaiting Lists