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Risk factors for morbidity and mortality in pediatric patients with peritoneal dialysis catheters.
MedLine Citation:
PMID:  23331815     Owner:  NLM     Status:  In-Data-Review    
PURPOSE: As peritoneal dialysis (PD) is the preferred long-term dialysis modality in the pediatric population, we sought to identify risk factors for mortality and reoperation.
METHODS: A retrospective review of patients undergoing PD catheter insertions at a single center from 1994-2009 was performed. The following variables were evaluated: age (<1year), comorbidities, omentectomy, concomitant gastrostomy, and laparoscopic technique. Multivariable Cox regressions analyses were used to evaluate patient survival and reoperation-free survival of PD catheters.
RESULTS: 207 patients with a median age of 10years underwent PD insertion. Mortality was 7% with a median follow up of 72months. Reoperation for malfunction and infection was required in 49% of patients with a median PD catheter survival of 11months. Reoperation for hernias occurred in 14% of patients. Multivariate Cox regressions analyses identified age <1year, lack of omentectomy, concomitant gastrostomy, and prematurity as variables significantly associated with higher rates of mortality or reoperation.
CONCLUSIONS: In this large study of pediatric patients undergoing PD, higher complication rates were noted in infants less than one year of age. Concomitant gastrostomy was associated with a higher rate of reoperation for infection. Failure to perform omentectomy was associated with a higher rate of catheter failure.
Jennifer Phan; Steve Stanford; Joshua J Zaritsky; Daniel A Deugarte
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  48     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  197-202     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
David Geffen School of Medicine at UCLA.
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