Gastroschisis prognostic score predicts high-risk newborns with gastroschisis in a middle-income country

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INTRODUCTION: The Gastroschisis Prognostic Score (GPS) stratifies patients as high or low-risk based on the visual assessment of intestinal matting, atresia, perforation, or necrosis shortly after birth. Its applicability to low and middle-income settings remains unknown. This study aimed to validate the GPS as a prognostic tool in a public hospital within a middle-income country. METHODS: With REB approval, we conducted a prospective study of all newborns with gastroschisis in a Brazilian neonatal public hospital from 2015-2019. Infants were stratified into low and high-risk cohorts based on the GPS. In addition to basic demographics, data collected included duration of parenteral nutrition (TPN), mechanical ventilation (MV), length of stay (LOS), sepsis, and mortality. Univariate and multivariate analyses were conducted to identify which outcomes the GPS independently predicted.RESULTS: Sixty-one newborns with gastroschisis were treated in our center. The mean birth weight, gestational age, and 5’ Apgar score were 2258g, 36weeks, and 9. Accordingly to the GPS, 24 infants (39.3%) were identified as low-risk and 37 (60.7%) as high-risk. The high-risk group presented with prolonged use of TPN (p<0.001), MV (p<0.001), and LOS (p:0.002). There was no association between GPS with sepsis or mortality in this study. CONCLUSION: This is the first study that validates the GPS as a prognostic tool in a middle-income country. Several important outcome measures were predicted by the GPS allowing for better parental counseling and resource allocation. The GPS is a reliable tool that can be used in various resource settings.

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Gastrosquise, Países em Desenvolvimento, Brasil

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Gastrosquise, Países em Desenvolvimento

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https://www.sciencedirect.com/science/article/pii/S1072751521016471

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