Clinical features and practice patterns of gastroschisis: a retrospective analysis using a Japanese national inpatient database.
PURPOSE
The number of infants with gastroschisis is increasing worldwide, but advances in neonatal intensive care and parenteral nutrition have reduced gastroschisis mortality. Recent clinical data on gastroschisis are often from Western nations. This study aimed to examine clinical features and practice patterns of gastroschisis in Japan.


METHODS
We examined treatment options, outcomes, and discharge status among inpatients with simple gastroschisis (SG) and complex gastroschisis (CG), 2010-2016, using a national inpatient database in Japan.


RESULTS
The 247 eligible patients (222 with SG) had average birth weight of 2102 g and average gestational age of 34 weeks; 30% had other congenital anomalies. Digestive anomalies were most common, followed by circulatory anomalies. In-hospital mortality was 8.1%. The median age at start of full enteral feeding was 30 days. The median length of stay was 46 days. There were no significant differences in outcomes except for length of stay, starting full enteral feeding and total hospitalization costs between the SG and CG groups. About 80% of patients were discharged to home without home medical care. The readmission rate was 28%.


CONCLUSION
This study's findings on the clinical characteristics and outcomes of gastroschisis are useful for the clinical management of gastroschisis.
['Fujiogi|Michimasa|M|', 'Michihata|Nobuaki|N|', 'Matsui|Hiroki|H|', 'Fushimi|Kiyohide|K|', 'Yasunaga|Hideo|H|', 'Fujishiro|Jun|J|']
D000015:Abnormalities, Multiple D001724:Birth Weight D016208:Databases, Factual D004750:Enteral Nutrition D005260:Female D020139:Gastroschisis D005865:Gestational Age D017052:Hospital Mortality D006801:Humans D007231:Infant, Newborn D007564:Japan D007902:Length of Stay D008297:Male D010359:Patient Readmission D012189:Retrospective Studies
Gastroschisis Neonatal Complex gastroschisis Abdominal wall defect Pediatric surgery