TY - JOUR
T1 - Age and Weight Stratified Outcomes of Single Stage Endorectal Pull-through Procedures for Hirschsprung's Disease in Children
T2 - Analysis of NSQIP-P Data
AU - Thobani, Humza
AU - Tahan, Daniel
AU - Shah, Adil A.
AU - Raymond, Steven L.
AU - Chiu, Bill
AU - Islam, Saleem
AU - Khan, Faraz A.
N1 - Publisher Copyright:
© 2025
PY - 2025
Y1 - 2025
N2 - Background: We aimed to analyze the effect of age and weight on 30-day outcomes of single-stage endorectal pull tthrough (ERPT) procedures for Hirschsprung's Disease (HD) using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database to identify an optimal time for surgery. Methods: We queried NSQIP-P for children <2 years with HD who underwent ERPT between 2016-2021 and did not have a preoperative stoma. Patients were stratified by age (<3 months, 3–6 months and >6 months) and weight (<4 kg, 4–8 kg, and >8 kg) at the time of surgery. The primary outcome measure was major adverse outcomes, and the secondary outcomes were 30-day unplanned readmission and reoperation. Multivariable logistic regression was conducted to analyze the association between age and weight and each outcome. Results: A total of 1002 patients were included with a median age of 31 days (IQR: 10–106 days). Patients were stratified by age (n = 702, 70.1 %; n = 158, 15.8 %; n = 142, 14.2 % respectively from youngest to oldest) and weight (n = 472, 47.1 %; n = 421, 42.0 %; n = 109, 10.9 % respectively from lowest to highest weight) groups. On multivariable analysis, age>6 months and weight>8 kg were independently associated with a higher rate of major complications (aOR = 2.741, 95 % C.I. = 1.234–5.880 and aOR = 4.627, 95 % C.I. = 1.761–11.775 respectively). Conversely, being in the highest age (aOR = 0.359, 95 % C.I. = 0.176–0.699) and weight brackets (aOR = 0.396, 95 % C.I. = 0.171–0.801) independently predicted lower 30-day readmission rates. Conclusion: Earlier single-stage ERPT for HD was found to be associated with lower complication rates in a select group of patients but may result in increased rates of readmissions and hospital resource utilization. Level of Evidence: Level III evidence. Type of Study: Retrospective cohort study.
AB - Background: We aimed to analyze the effect of age and weight on 30-day outcomes of single-stage endorectal pull tthrough (ERPT) procedures for Hirschsprung's Disease (HD) using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database to identify an optimal time for surgery. Methods: We queried NSQIP-P for children <2 years with HD who underwent ERPT between 2016-2021 and did not have a preoperative stoma. Patients were stratified by age (<3 months, 3–6 months and >6 months) and weight (<4 kg, 4–8 kg, and >8 kg) at the time of surgery. The primary outcome measure was major adverse outcomes, and the secondary outcomes were 30-day unplanned readmission and reoperation. Multivariable logistic regression was conducted to analyze the association between age and weight and each outcome. Results: A total of 1002 patients were included with a median age of 31 days (IQR: 10–106 days). Patients were stratified by age (n = 702, 70.1 %; n = 158, 15.8 %; n = 142, 14.2 % respectively from youngest to oldest) and weight (n = 472, 47.1 %; n = 421, 42.0 %; n = 109, 10.9 % respectively from lowest to highest weight) groups. On multivariable analysis, age>6 months and weight>8 kg were independently associated with a higher rate of major complications (aOR = 2.741, 95 % C.I. = 1.234–5.880 and aOR = 4.627, 95 % C.I. = 1.761–11.775 respectively). Conversely, being in the highest age (aOR = 0.359, 95 % C.I. = 0.176–0.699) and weight brackets (aOR = 0.396, 95 % C.I. = 0.171–0.801) independently predicted lower 30-day readmission rates. Conclusion: Earlier single-stage ERPT for HD was found to be associated with lower complication rates in a select group of patients but may result in increased rates of readmissions and hospital resource utilization. Level of Evidence: Level III evidence. Type of Study: Retrospective cohort study.
KW - Age
KW - Endorectal pull-through
KW - Hirschsprung disease
KW - Outcomes
KW - Timing
KW - Weight
UR - http://www.scopus.com/inward/record.url?scp=85215360413&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2025.162168
DO - 10.1016/j.jpedsurg.2025.162168
M3 - Article
AN - SCOPUS:85215360413
SN - 0022-3468
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
M1 - 162168
ER -