157 Central venous catheter associated bloodstream infections and thrombosis in patients treated for gastroschisis and intestinal atresia Chapter 6 between those that experienced a CLABSI and those that didn’t. Also, patients treated for a complex gastroschisis did not develop significantly more CLABSIs than patients treated for isolated gastroschisis (p = 0.08) Catheter dwell time was found to be an effect modifier, differing significantly between tunnelled and non-tunnelled catheters. Therefore, this variable was excluded from the model. Stratifying both groups showed that the dwell time in non-tunnelled central venous catheter was significantly (p < 0.01) shorter than in tunnelled catheters. Tunnelled central venous catheters stayed inserted for a median of 23 days (IQR: 15 -35) and nontunnelled catheters a median of 14 days (IQR: 8 -22). CLABSIs developed in a significantly shorter dwell time in non-tunnelled central venous catheters compared to tunnelled central venous catheters (p = 0.02). The Kaplan-Meier curve, shown in Figure 1, visualizes this difference in time to CLABSI occurrence in tunnelled versus non-tunnelled catheters (log-rank test: p < 0.01). Table 1 - Patient characteristics Total number of patients = 238 Count (% of total) Mean birthweight in grams (± Std) 2551 (652) (Missing: 53) Male 124 (52%) Premature 97 (41%) (Missing: 13) Down syndrome 32 (13%) Median age at surgery (IQR) 2 days (1 – 4) Treatment for Intestinal atresia 175 (73%) Gastroschisis 63 (27%) Comorbidity*1 Duodenal web 28 (12%) Annular pancreas 24 (10%) Malrotation 22 (9%) Midgut volvulus 7 (3%) Meconium peritonitis 10 (4%) Patients treated for complex gastroschisis 14 (6%) Gastroschisis treated by primary closure*2 40 (64%) Patients who received an enterostomy 55 (23%) Clavien-Dindo ≥ III following surgery 53 (22%) (Missing: 2) Median duration of hospital stay (IQR) 27 days (18 – 42) Median number of abdominal procedures (IQR) 1 (1-2) Mortality within 30 days 4 (2%) Overall mortality 16 (7%) Median months length of follow-up (IQR) 24 months (8 – 79) *1: Five patients experienced a malrotation + duodenal web, one a malrotation + volvulus and one an annular pancreas + malrotation. *2: Of all complex gastroschisis patients, eight (57%) were treated by primary closure.
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