This is a multi-center retrospective chart review to compile a data repository of the management and outcomes of children with biliary atresia. Overall, investigators aim to evaluate which specific factors contribute to improved patient outcomes, to help guide potential improvements in patient care and resource utilization.
Biliary atresia is quite rare, with only 0.73 cases per 10,000 births in the US. Due to this rarity and the geographical spread of the US, the small number of cases end up being dispersed amongst the various pediatric hospitals, which leads to certain hospitals only encountering an affected patient once per decade. This rarity and dispersion makes biliary atresia difficult for researchers to study: single-institution studies are limited by low power and only provide narrow snapshots, whereas large NIH-sponsored consortia report highly selected outcomes from only the largest or most dedicated centers and have largely excluded New England. This leaves a significant knowledge gap regarding the management and outcomes at more typical hospitals. The purpose of this study is to collect clinical data from all children with biliary atresia at all hospitals providing pediatric surgical care in the Northeast, even very-low-volume hospitals. This is a retrospective study, only involving chart review. There will be no interaction with subjects, intervention, or collection of specimens for the purposes of this study. The data will only include clinical information that was recorded during the normal course of patient care. The subjects will be de-identified before entry into a HIPAA-compliant data repository. This data repository will allow researchers to pool data, to yield adequate statistical power and assess differences in management and outcomes regarding this very rare condition.
Study Type
OBSERVATIONAL
Enrollment
150
Connecticut Children's Medical Center
Hartford, Connecticut, United States
RECRUITINGYale University
New Haven, Connecticut, United States
Death
Patient death
Time frame: 10 years
Kasai procedure
Need for biliary diversion procedure, including the Kasai portoenterostomy
Time frame: 10 years
Liver transplant
Need for liver transplant
Time frame: 10 years
Clearance of jaundice
Normalization of serum bilirubin after Kasai procedure
Time frame: 6 months
Bilirubin level
Serum bilirubin level
Time frame: 10 years
Cholangitis
Clinical diagnosis of cholangitis
Time frame: 10 years
Bleeding
Post-operative bleeding requiring transfusion or return to the OR
Time frame: 10 years
Presentation to ED
Patient presentation to the ED for complication related to biliary atresia
Time frame: 10 years
Age at follow-up with providers
Frequency and age at most recent follow-up with Pediatric Surgeon and/or Hepatologist
Time frame: 10 years
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Eastern Maine Medical Center
Bangor, Maine, United States
RECRUITINGMaine Medical Center
Portland, Maine, United States
RECRUITINGMassachusetts General Hospital for Children
Boston, Massachusetts, United States
RECRUITINGBoston Children's Hospital
Boston, Massachusetts, United States
RECRUITINGBaystate
Springfield, Massachusetts, United States
RECRUITINGUMass Memorial Medical Center
Worcester, Massachusetts, United States
RECRUITINGDartmouth-Hitchcock Medical Center
Lebanon, New Hampshire, United States
RECRUITINGAlbany Medical Center/Bernard & Millie Duke's Children's Hospital
Albany, New York, United States
RECRUITING...and 4 more locations