Recurrent gastrojejunostomy tube dislodgement/dysfunction in pediatric patients: an analysis of biologic and sociodemographic factors that predict frequent replacements Restricted; Files Only

Cantey, Meghann (Summer 2022)

Permanent URL: https://etd.library.emory.edu/concern/etds/hx11xg58k?locale=pt-BR
Published

Abstract

Objective: This study aims to determine whether certain biological and sociodemographic factors influence the frequency of gastrojejunostomy tube (GJT) dislodgements or dysfunction in children requiring GJT replacement in interventional radiology (IR) at Children’s Healthcare of Atlanta (CHOA) in Atlanta, GA.

 

Design: Primary analysis of longitudinal GJT replacement data obtained from CHOA in Atlanta, Georgia from October 2018- October 2021.

Methods: Children were grouped by disease origin: congenital anomalies without known genetic component (reference group), chromosomal abnormalities, and postnatal injuries, and the incidence of replacements were compared according to several biological and sociodemographic characteristics using negative binomial regression.

Results: 430 children were included in the analysis. Incidence rate ratios (IRRs) for GJT replacements for children with chromosomal abnormalities (n= 132) was 0.83 [95% confidence interval (95% CI): 0.72- 0.96] times that of children with congenital anomalies. Children with postnatal injuries had an IRR 0.83 times that of children with congenital anomalies (95% CI: 0.70- 0.98). Female children had IRRs 0.87 times that of male children (95% CI: 0.76- 0.98). Black children had an IRR 1.15 times that of White children (95% CI: 1.00- 1.32), while the IRR comparing Asian and Other race children to White and to Black was not statistically significant. Race was found to confound the association. Home health care was strongly associated with the number of GJT replacements with our analysis showing that those without home care had an IRR 1.47 times that of children with (95% CI: 1.11- 1.96). Our analysis did not find any statistical significance related to parents’ employment status, ethnicity, preferred language, or Gini Index.

 

Conclusion: Among children with congenital anomalies, Black children, and children without home health care, we observed an increased incidence of GJT replacements compared with White children, children with chromosomal abnormalities and postnatal injuries, and those with home health care. The strongest association was observed in those children without home health.

Table of Contents

Chapter 1: Background Literature Review

Introduction

Background

Risks and Complications

Exogenous risks and considerations

Areas of development

Evidence Gaps

Statement of problem

Purpose of the Study

Public Health Implications

Chapter 2: Journal Article

Abstract

Introduction

Methods

Results

Discussion

Tables and Figures

Chapter 3

Future Directions/ Public Health Implications

References

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