732 - Epidemiological and Clinical Factors Affecting Pre-Discharge Inguinal Hernia Repair in Preterm Infants: Analysis from National Cohort

Poster Number: 732
Publication Number: 732.244

Nilesh Dankhara, University of Mississippi Medical Center, Jackson, MS, United States; Aditya S. Patel, Jackson State University, Jackson, MS, United States; Chintan Desai, Mississippi State Department of Health, Jackson, MS, United States; Ashish A Sonani, Surat Civil Hospital, Surat, Gujarat, India; Jagdish Desai, Pediatrix Medical Group, Austin, TX, United States

Background: There are still significant epidemiological and clinical practice variations in managing inguinal hernia (IH) in preterm infants. There is no clear evidence of pre-discharge vs. post-discharge repair, so there is a huge variation in the practice. Also, it is unknown which epidemiological and clinical factors predict pre- vs. post-discharge repair.

Objective: To study current trends in the practice of managing inguinal hernia in preterm infants with specific aims (i) to evaluate trends of  IH repair in preterm infants in the USA from the year 2000 to 2019, (ii) to examine postnatal age when IH repair happens pre-discharge and (iii) to study clinical and epidemiological factors predicting pre-discharge repair.

Design/Methods: We accessed the national multicenter Kids’ Inpatient Database (KID) Healthcare Cost and Utilization Project (HCUP) from 2000 to 2019. Eligible infants were identified by using ICD-9 and ICD-10 codes of inguinal hernia in infants with gestational age (GA) ≤37 weeks during those years.  A weight-based analysis was performed using SAS Enterprise Guide 9.4 for complex sample design.

Results: A total of 2,303,823 preterm infants were analyzed in this cohort. The prevalence of IH was 7.5 cases per 1000 preterm births overall and 41 cases per 1000 very low birth weight (VLBW) infants. The trend of IH and IH repair has been described in Figure 1. The odds of IH was significantly higher in VLBW infants with BPD as compared to no BPD (OR: 3.83, CI: 3.67-4.01, p< 0.001). Mean time for repair was 123 days (Corrected gestation of 40-41 weeks) in infants ≤24 weeks at birth (Figure 2), Factors predicting pre-discharge IH repair were lower gestational age ≤ 24 weeks, presence of BPD, white race, female gender, teaching hospital, and Midwest region (Figure 3).

Conclusion(s): To our knowledge, this is the largest cohort evaluating IH in preterm infants. It shows an increasing trend of IH in VLBW infants and an increasing rate of pre-discharge repairs in all preterm infants. Teaching hospitals had a significantly high rate of IH repair pre-discharge.