Abstract
Background
Males and females are known to have varied responses to medical interventions. Our
study aimed to determine the effect of sex on surgical outcomes after pyloromyotomy.
Materials and methods
Using the Kids' Inpatient Database for the years 2003-2012, we performed a serial,
cross-sectional analysis of a nationally representative sample of all patients aged
<1 y who underwent pyloromyotomy for hypertrophic pyloric stenosis. The primary predictor
of interest was sex. Outcomes included mortality, in-hospital complications, cost,
and length of stay. Regression models were adjusted by race, age group, comorbidity,
complications, and whether operation was performed on the day of admission with region
and year fixed effects.
Results
Of 48,834 weighted operations, 81.8% were in males and 18.2% were in females. The
most common reported race was white (47.3%) and most of the patients were ≥29 days
old (72.5%). There was no difference in the odds of postoperative complications, but
females had a significantly longer length of stay (incidence rate ratio, 1.28; 95%
confidence interval [95% CI], 1.18-1.39; P ≤ 0.01), higher cost (5%, 95% CI, 1.02-1.08; P ≤ 0.01), and higher odds of mortality (odds ratio, 3.26; 95% CI, 1.52-6.98; P ≤ 0.01).
Conclusions
Our study demonstrated that females had worse outcomes after pyloromyotomy compared
with males. These findings are striking and are important to consider when treating
either sex to help set physician and family expectations perioperatively. Further
studies are needed to determine why such differences exist and to develop targeted
treatment strategies for both females and males with pyloric stenosis.
Keywords
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Article Info
Publication History
Published online: August 14, 2019
Accepted:
July 16,
2019
Received in revised form:
June 14,
2019
Received:
March 1,
2019
Footnotes
Oral presentation at the 2019 Academic Surgical Congress on February 6, 2019, in Houston, TX.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
