Differences in Outcomes Based on Sex for Pediatric Patients Undergoing Pyloromyotomy

Copyright © 2019 Elsevier Inc. All rights reserved..

BACKGROUND: Males and females are known to have varied responses to medical interventions. Our study aimed to determine the effect of sex on surgical outcomes after pyloromyotomy.

MATERIALS AND METHODS: Using the Kids' Inpatient Database for the years 2003-2012, we performed a serial, cross-sectional analysis of a nationally representative sample of all patients aged <1 y who underwent pyloromyotomy for hypertrophic pyloric stenosis. The primary predictor of interest was sex. Outcomes included mortality, in-hospital complications, cost, and length of stay. Regression models were adjusted by race, age group, comorbidity, complications, and whether operation was performed on the day of admission with region and year fixed effects.

RESULTS: Of 48,834 weighted operations, 81.8% were in males and 18.2% were in females. The most common reported race was white (47.3%) and most of the patients were ≥29 days old (72.5%). There was no difference in the odds of postoperative complications, but females had a significantly longer length of stay (incidence rate ratio, 1.28; 95% confidence interval [95% CI], 1.18-1.39; P ≤ 0.01), higher cost (5%, 95% CI, 1.02-1.08; P ≤ 0.01), and higher odds of mortality (odds ratio, 3.26; 95% CI, 1.52-6.98; P ≤ 0.01).

CONCLUSIONS: Our study demonstrated that females had worse outcomes after pyloromyotomy compared with males. These findings are striking and are important to consider when treating either sex to help set physician and family expectations perioperatively. Further studies are needed to determine why such differences exist and to develop targeted treatment strategies for both females and males with pyloric stenosis.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:245

Enthalten in:

The Journal of surgical research - 245(2020) vom: 01. Jan., Seite 207-211

Sprache:

Englisch

Beteiligte Personen:

Massoumi, Roxanne L [VerfasserIn]
Sakai-Bizmark, Rie [VerfasserIn]
Tom, Cynthia M [VerfasserIn]
Howell, Erin [VerfasserIn]
Childers, Christopher P [VerfasserIn]
Jen, Howard C [VerfasserIn]
Lee, Steven L [VerfasserIn]

Links:

Volltext

Themen:

Female
Gender
Journal Article
Male
Pyloromyotomy
Research Support, Non-U.S. Gov't
Sex differences

Anmerkungen:

Date Completed 19.02.2020

Date Revised 29.03.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.jss.2019.07.042

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM300315953