Biliary Atresia in Preterm Infants in Taiwan: A Nationwide Survey
ABSTRACT OBJECTIVES: To investigate the characteristics of biliary atresia (BA) in preterm infants. STUDY DESIGN: Nationwide screening for BA in Taiwan using an infant stool color card was launched in 2004. We investigated the characteristics of BA in preterm infants using the national stool card registry center database. RESULTS: We identified 197 cases of BA from January 2004 to June 2010. The overall incidence of BA was 1.51 cases per 10 000 live births. The annual incidence of BA per 10 000 live births in term and preterm infants was 1.43 and 2.37 (P < .05), respectively. The sensitivity of detecting BA using stool cards before 60 days of age was 92.8% in term, and 96.3% in preterm infants. The Kasai operation before 60 days of age was 68.7% in term, and 44.4% in preterm infants. The jaundice-free rate at 3 months after the Kasai operation among infants with BA was 62.0% in term, and 37.0% in preterm infants (P = .015). The 18-month survival rate with native liver was higher in the term infants (72.7%) than that in the preterm infants (50.0%) (P = .043). CONCLUSION: The incidence of BA in preterm infants is more frequent than in term infants. The stool color card is sensitive to detecting BA in preterm infants. Preterm infants with BA were more prone to delayed Kasai operation and had poorer outcome.
- Journal of Hepatology 06/2013; 56(4). DOI:10.1016/j.jhep.2013.06.006 · 10.40 Impact Factor
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ABSTRACT: The purpose of this study was to determine reliable predictors of outcome of biliary atresia (BA) after Kasai's operation. This study included two consecutive stages of infants with biliary atresia. First stage, 200 BA cases who underwent Kasai's operation at our institution between May 2006 and May 2010 were retrospectively reviewed. In the first stage, we wanted to calculate a clinical scoring system by logistic regression. For cut-off determination, receiver operating characteristic (ROC) analysis was employed. Second stage (validation of scoring system), we used our scoring system to prospectively predict the outcomes of patients underwent a Kasai operation from inspecting the accuracy of our system. Early cholangitis, age at operation, JC time, post-operative TB, DB, AST, ALT and surgical method entered into our scoring system. The most reliable cut-offs determined by ROC analysis were 7.71 (sensitivity: 86.0 %, specificity: 98.0 %). We used our scoring system to predict the prognosis of the 15 BA patients and found that 13 of 15 patients were correctly predicted at the cut-off value of 7.71. Our scoring system is considered to be a reliable and useful predictor of the prognosis of biliary atresia.Pediatric Surgery International 04/2015; 31(6). DOI:10.1007/s00383-015-3710-3 · 1.06 Impact Factor