• Afif N Kulaylat, Christopher S Hollenbeak, Brett W Engbrecht, Peter W Dillon, and Shawn D Safford.
• Division of Pediatric Surgery, Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, United States; Division of Outcomes, Research and Quality, Department of Surgery and Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, PA, United States.
• J. Pediatr. Surg. 2015 Mar 1; 50 (3): 417-22.

BackgroundThe benefit of Ladd's procedure for malrotation at a Children's Hospital (CH) has not previously been established. Our aim was to characterize the potential variations in management and outcomes between CH and Non-Children's Hospitals (NCH) in the treatment of malrotation with Ladd's procedure.MethodsThere were 2827 children identified with malrotation and complete information from the Kids' Inpatient Database (2003, 2006, 2009). Outcomes were compared between CH and NCH and evaluated with logistic and linear regressions. Additional propensity score matching was used to balance covariates between CH and NCH.ResultsThere were 2261 (80.0%) children with malrotation undergoing Ladd's procedures treated at CH; 566 (20.0%) were treated at NCH. In multivariate analysis, CH was associated with a 39% lower odds of resection (p=0.004), with no differences observed for mortality, morbidity and LOS. Comparison of a propensity score matched cohort confirmed these findings, as well as demonstrated no significant differences in associated costs.ConclusionsThe majority of pediatric intestinal malrotation is managed at CH. While measured outcomes of mortality, morbidity, LOS, and costs were not different at NCH, CH was less likely to perform intestinal resection during Ladd's procedure.Copyright © 2015 Elsevier Inc. All rights reserved.

27 keywords...

hide…