Does Age Matter? Comparing Post-Operative Outcomes Following Gastrostomy Tube Placement in Young Children: a NSQIP-Pediatric Study.

PURPOSE: Young infants may be at higher risk of complications after gastrostomy tube (GT) placement and may benefit from a prolonged nasogastric tube (NGT) feeding trial. The purpose of this study was to determine whether age at time of GT placement is associated with post-operative complications. METHODS: Using the American College of Surgeons' National Surgical Quality Improvement Program-Pediatric database, we identified children aged 0-18 months who underwent GT placement between 2014-2024. Patients who underwent major concurrent procedures were excluded. A multivariable logistic regression model was used to identify factors associated with 30-day complications. We compared composite 30-day complications across three age groups: 1) <60 days, 2) 60 days to 6 months, and 3) 7- to 18 months. RESULTS: We identified 33,973 patients, 25.0% were <60 days, 45.7% were 60 days to 6 months, and 29.3% were 7- to 18 months. Patients <60 days had the highest percentage of 30-day complications (12.4%), compared to patients 60 days to 6 months (9.3%) and 7- to 18 months (6.6%) (p<0.0001). On multivariable regression, age was associated with post-operative morbidity, as were prematurity, underlying comorbidities, ASA class, and steroid use. Post-operative length of stay (LOS) was longest in patients <60 days [6 days, interquartile range (IQR) 4-10] and patients 60 days to 6 months (6 days, IQR 2-10) compared to patients 7- to 18 months (2 days, IQR 1-4) (p<0.0001). CONCLUSIONS: Children aged <60 days have the highest proportion of 30-day complications following GT placement. Because of the known fragility of very young infants, delaying GT placement in this age group may confer some benefit.