Inter-center variations in length of hospitalization for infants with congenital jejunal or ileal atresia

Katie A Huff^{1

2

3}, Isabella Zaniletti⁴, Kera McNelis^{5

6}, Alan Ladd⁷, Abeer Azzuqa⁸, Carl H Coghill⁹, Daniel T Robinson¹⁰, Muralidhar H Premkumar¹¹, Patricia W Denning^{5

6}, Jae Kim^{2

3}, Mark R Corkins¹², Andrea Adler¹³, Darren Bodkin¹⁴, Jeffrey Rudolph¹⁵, Ashley Moore¹, Katie M Strobel¹⁶, Michael A Padula^{4

17}, Theresa R Grover^{4

18}, Karna Murthy^#^{4

10}, Sujir Pritha Nayak^#¹⁹; Children’s Hospitals Neonatal Consortium Intestinal Failure Focus Group

Collaborators, Affiliations

Collaborators

Children’s Hospitals Neonatal Consortium Intestinal Failure Focus Group:
Anthony Piazza, Gregory Sysyn, Ashley Lucke, Molly Pont, Allison Black, Carl Coghill, Anne Hansen, Eugenia Pallotto, Karna Murthy, Gustave Falciglia, Beth Haberman, Ceyda Acun, Thomas Bartman, Sushmita Yallapragada, Lina Chalak, Danielle Smith, Stephanie Bourque, Girija Natarajan, Annie Chi, Yvette Johnson, Annmarie Gotiolo, Kristina Reber, Rebecca Rose, Julie Lindower, Julie Weiner, Laura Carroll, Rachel Chapman, Nina Menda, Mark Weems, Ann Downey, Joanne Lagatta, Priscilla Joe, Trent Tipple, Patricia Williams, Nicole Birge, Michel Mikhael, Narendra Dereddy, Rajan Wadhawan, Aaron Weiss, Michael Padula, Vilarmis Quinones, Pam Griffiths, Toby Yanowitz, Ellen Bendel-Stenzel, Con Yee Ling, Mark Speziale, Robert DiGeronimo, Elizabeth Jacobsen, Beverly Brozanski, Rakesh Rao, Ann Downey, Linda Van Marter, Kyong-Soon Lee, Billie Lou Short, Kevin Sullivan, Cherrie Welch

Affiliations

¹ Division of Neonatal-Perinatal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
² Division of Neonatology, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Indianapolis, IN, USA.
³ Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
⁴ Children's Hospitals Neonatal Consortium Dover, Dover, DE, USA.
⁵ Children's Healthcare of Atlanta, Atlanta, GA, USA.
⁶ Emory University, Atlanta, GA, USA.
⁷ Division of Pediatric Surgery, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA.
⁸ University of Pittsburgh School of Medicine & UPMC Children's Hospital of Pittsburgh, Department of Pediatrics, Division of Newborn Medicine, Pittsburgh, PA, USA.
⁹ Children's of Alabama and The Division of Neonatology, University of Alabama Birmingham, Birmingham, AL, USA.
¹⁰ Ann & Robert H. Lurie Children's Hospital of Chicago; Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
¹¹ Division of Neonatology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
¹² Division of Gastroenterology, Department of Pediatrics, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN, USA.
¹³ Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic Children's Hospital, Cleveland, OH, USA.
¹⁴ Section of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Oklahoma Health College of Medicine, Oklahoma City, OK, USA.
¹⁵ University of Pittsburgh School of Medicine & UPMC Children's Hospital of Pittsburgh, Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Pittsburgh, PA, USA.
¹⁶ Division of Neonatology, University of Washington, Seattle, WA, USA.
¹⁷ Children's Hospital of Philadelphia and University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.
¹⁸ Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA.
¹⁹ Division of Neonatal-Perinatal Medicine University of Texas Southwestern Medical Center, Dallas, TX, USA. pritha.nayak@utsouthwestern.edu.

^# Contributed equally.

PMID: 41310308
DOI: 10.1038/s41372-025-02481-0

Inter-center variations in length of hospitalization for infants with congenital jejunal or ileal atresia

Katie A Huff et al. J Perinatol. 2025.

. 2025 Nov 27.

doi: 10.1038/s41372-025-02481-0. Online ahead of print.

Authors

Collaborators

Children’s Hospitals Neonatal Consortium Intestinal Failure Focus Group:
Anthony Piazza, Gregory Sysyn, Ashley Lucke, Molly Pont, Allison Black, Carl Coghill, Anne Hansen, Eugenia Pallotto, Karna Murthy, Gustave Falciglia, Beth Haberman, Ceyda Acun, Thomas Bartman, Sushmita Yallapragada, Lina Chalak, Danielle Smith, Stephanie Bourque, Girija Natarajan, Annie Chi, Yvette Johnson, Annmarie Gotiolo, Kristina Reber, Rebecca Rose, Julie Lindower, Julie Weiner, Laura Carroll, Rachel Chapman, Nina Menda, Mark Weems, Ann Downey, Joanne Lagatta, Priscilla Joe, Trent Tipple, Patricia Williams, Nicole Birge, Michel Mikhael, Narendra Dereddy, Rajan Wadhawan, Aaron Weiss, Michael Padula, Vilarmis Quinones, Pam Griffiths, Toby Yanowitz, Ellen Bendel-Stenzel, Con Yee Ling, Mark Speziale, Robert DiGeronimo, Elizabeth Jacobsen, Beverly Brozanski, Rakesh Rao, Ann Downey, Linda Van Marter, Kyong-Soon Lee, Billie Lou Short, Kevin Sullivan, Cherrie Welch

Affiliations

¹ Division of Neonatal-Perinatal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
² Division of Neonatology, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Indianapolis, IN, USA.
³ Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
⁴ Children's Hospitals Neonatal Consortium Dover, Dover, DE, USA.
⁵ Children's Healthcare of Atlanta, Atlanta, GA, USA.
⁶ Emory University, Atlanta, GA, USA.
⁷ Division of Pediatric Surgery, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA.
⁸ University of Pittsburgh School of Medicine & UPMC Children's Hospital of Pittsburgh, Department of Pediatrics, Division of Newborn Medicine, Pittsburgh, PA, USA.
⁹ Children's of Alabama and The Division of Neonatology, University of Alabama Birmingham, Birmingham, AL, USA.
¹⁰ Ann & Robert H. Lurie Children's Hospital of Chicago; Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
¹¹ Division of Neonatology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
¹² Division of Gastroenterology, Department of Pediatrics, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN, USA.
¹³ Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic Children's Hospital, Cleveland, OH, USA.
¹⁴ Section of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Oklahoma Health College of Medicine, Oklahoma City, OK, USA.
¹⁵ University of Pittsburgh School of Medicine & UPMC Children's Hospital of Pittsburgh, Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Pittsburgh, PA, USA.
¹⁶ Division of Neonatology, University of Washington, Seattle, WA, USA.
¹⁷ Children's Hospital of Philadelphia and University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.
¹⁸ Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA.
¹⁹ Division of Neonatal-Perinatal Medicine University of Texas Southwestern Medical Center, Dallas, TX, USA. pritha.nayak@utsouthwestern.edu.

^# Contributed equally.

PMID: 41310308
DOI: 10.1038/s41372-025-02481-0

Abstract

Objective: To quantify inter-center variation (ICV) in length of stay (LOS) among surviving infants with jejunal (JA) or ileal atresia (IA).

Study design: Children's Hospitals Neonatal Consortium's database was used to identify infants with JA or IA. After excluding infants with abdominal wall defects, survivors' hospital LOS was modeled as a function of center using generalized linear models with log link for gamma distribution.

Results: There were 1134 and 808 infants with JA and IA, respectively. LOS had significant ICV in unadjusted (JA: 5.4 [IQR 3.7,9.9] weeks; IA: 4.3 [IQR 2.4,11.4] weeks) and multivariable analyses (JA: 4+ fold difference (6.5-31.5 week); p < 0.001 IA: 8+ fold difference (1.7-14.6 weeks); p < 0.001) with modifiable risk factors including cholestasis, ostomy creation, blood stream infection, and residual bowel length <55 cm.

Conclusion: Risk-adjusted ICV in LOS was observed in infants with JA and IA, which exposes opportunities for improvements in outcomes for infants with intestinal atresia.

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Conflict of interest statement

Competing interests: Jae Kim is a consultant for Medela, Carag, Biomilq, Cardinal Health, Mother’s Milk is Best. Jae Kim has shares in Astate Medical, Nicolette, Cardinal Health. Jae Kim has sponsored research with Fresenius-Kabi. Michael Padula, Theresa Grover, and Karna Murthy are board members of CHNC. A portion of Theresa Grover’s and Karna Murthy’s faculty effort is supported by CHNC. Theresa Grover is present of CHNC. Funding: CHNC funded the analytic support for this project and supported a portion of Dr. Murthy’s faculty effort from 2023-2024 to complete this work. Ethics approval and consent to participate: Each individual CHNC site has received local ethical oversight for data entry into CHND, and the Stanley Manne Research Institute at Ann & Robert H. Lurie Children’s Hospital of Chicago provided an exemption to analyze de-identified data from CHND (IRB#: 2011-14673). Informed consent has been waived for data entry into CHND. This study was performed in accordance with the Declaration of Helsinki.

References

1. Schmedding A, Hutter M, Gfroerer S, Rolle U. Jejunoileal Atresia: A National Cohort Study. Front Pediatr. 2021;9:665022. - DOI - PubMed - PMC
1. Hillyer MM, Baxter KJ, Clifton MS, Gillespie SE, Bryan LN, Travers CD, et al. Primary versus secondary anastomosis in intestinal atresia. J Pediatr Surg. 2019;54:417–22. - DOI - PubMed
1. Burjonrappa SC, Crete E, Bouchard S. Prognostic factors in jejuno-ileal atresia. Pediatr Surg Int. 2009;25:795–8. - DOI - PubMed
1. Hosokawa T, Tanami Y, Sato Y, Ishimaru T, Kawashima H, Oguma E. Incidence of late severe intestinal complications after bowel atresia/stenosis. Pediatr Int. 2022;64:e15208. - DOI - PubMed
1. Kielt MJ, Zaniletti I, Lagatta JM, Padula MA, Grover TR, Porta NFM, et al. Liberation from Respiratory Support in Bronchopulmonary Dysplasia. J Pediatr. 2024;282:114390.

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Inter-center variations in length of hospitalization for infants with congenital jejunal or ileal atresia

Collaborators

Affiliations

Inter-center variations in length of hospitalization for infants with congenital jejunal or ileal atresia

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

References

LinkOut - more resources

Full Text Sources