The Prognostic Impact of Defect Size Based on Body Surface Area in Omphaloceles

Introduction

This study addresses the existing gaps in understanding the cases with omphalocele by investigating the potential prognostic impact of the ratio between omphalocele diameter-and -body surface area (BSA), particularly in premature and low birth weight neonates.

Material and methods

Data retrieved from the hospital files of 25 patients with omphalocele related to their gestational histories, demographics, anthropometric data, comorbidities, defect diameters, and prognoses were retrospectively analyzed. BSA was calculated using the Haycock Formula. Binary logistic regression analysis performed identified mortality-associated factors.

Results

Most (84 %) of the patients with omphalocele, required mechanical ventilation, and the median hospital stay was 19 days. There was no significant correlation between defect diameter or defect diameter-to-BSA ratio and hospital stay. Mortality rate in these patients was 24 %, with a significantly higher mean (±SD) defect diameter-to-BSA ratio in non-survivors compared to survivors (467.9 ± 54.8 vs. 283.1 ± 24.8; p = 0.002). Logistic regression analysis identified the defect diameter-to-BSA ratio as a significant predictor of mortality (p = 0.023, Exp(B) = 1.038, 95 % CI: 1.005–1.072). Other variables, including defect size, cardiac anomalies, and solid organ presence in the sac, were not significant predictors.

Conclusion

This study underscores the superior prognostic value of the defect diameter-to-BSA ratio for omphalocele patients, surpassing conventional markers such as defect diameter, cardiac anomalies, and the presence of solid organs in the sac.