National and regional trends in gastrostomy in very low birth weight infants in the USA: 2000-2012

Objective To determine rates of gastrostomy (GT) in very low birth weight (VLBW) infants. Study design Retrospective, cross-sectional analysis of the Kids' Inpatient Database for the years 2000, 2003, 2006, 2009 and 2012. We identified VLBW births and infants undergoing a GT, with and without fundoplication, using ICD-9-CM codes. Result National rates (per 1000 VLBW births) of GT increased from 11.5 GT (95% CI 10-13) in 2000 to 22.9 (95% CI 20-25) in 2012 (p < 0.001). Gastrostomy with and without fundoplication increased during the study period (p < 0.001 in both groups). VLBW survival also increased from 78.5% in 2000 to 81.1% in 2012 (p < 0.001). In all study years, the Northeast census region had the lowest GT rates, while the West had the highest rates in 4 of the 5 study years. Conclusion Between 2000 and 2012, the incidence of GT in VLBW infants doubled, associated with improvements in survival in this population.