Am J Epidemiol. 2025 Aug 4:kwaf160. doi: 10.1093/aje/kwaf160. Online ahead of print.
ABSTRACT
The impact of delayed presentation to primary surgery on mortality and complication outcomes in children with gastrointestinal congenital anomalies is poorly understood. Using a cohort of 3767 children with gastrointestinal anomalies in 74 countries (2018-2019), we assessed predictors of delay and compare 30-day risk of all-cause mortality (ACM) and complication among children with delayed ($>$24 hours of life) versus non-delayed ($le$24 of life) presentation to primary surgery. Children in low-and middle-income countries (LMICs) had greater probability of delay (PR: 1.79; 95% CI: 1.59, 2.02) and mortality risk for all anomaly types compared to children in high-income countries (HICs). Compared to non-delayed children, delayed children with gastroschisis (RR: 1.62; 1.07, 2.47), omphalocele (RR: 1.17; 0.62, 2.21), intestinal atresia (RR: 1.88; 1.34, 2.63), and esophageal atresia (1.54; 1.15, 2.05) had greater ACM risk. Delayed children with gastroschisis (1.48; 1.25, 1.75) and esophageal atresia (1.17; 1.05, 1.30) had greater complication risk. Probability of delay and risk of death was higher in LMICs than HICs. Compared to non-delayed children, delayed children with gastroschisis, omphalocele, intestinal atresia, and esophageal atresia had greater 30-day ACM risk and delayed children with gastroschisis and esophageal atresia had greater 30-day complication risk.
PMID:40754788 | DOI:10.1093/aje/kwaf160
