{"doi":"10.1002/jpn3.70204","title":"Long‐term gastrointestinal outcomes in pediatric intestinal malrotation patients following operative treatment","abstract":"Intestinal malrotation (IM) is a rare congenital birth defect that occurs in utero due to failure of intestinal rotation and fixation into the normal anatomic position.1 Generally, IM is diagnosed once a patient experiences a life-threatening complication (e.g., midgut volvulus) or as part of the workup for gastrointestinal symptoms. For those with symptomatic IM and for some who are asymptomatic, operative treatment, typically the Ladd procedure, is often performed to reduce the likelihood of a future volvulus.2 Previous studies investigating outcomes after the Ladd procedure typically have focused only on short-term operative outcomes3-6 with only a few identifying ongoing gastrointestinal symptoms.4, 7-9 In this study, we used TriNetX, a large multi-institutional aggregated database of electronic medical records (EMRs), to estimate the rates of diagnosed gastrointestinal symptoms several years postoperative treatment for pediatric IM patients compared to a general pediatric cohort. West Virginia University's Institutional Review Board determined that this study does not meet the definition of human subjects research. Data were extracted on August 1st, 2024 from the TriNetX Research Network, which provides access to aggregated deidentified EMR for over 130 million patients from 92 healthcare organizations (HCOs) across the world. We conducted a retrospective matched cohort study of postoperative gastrointestinal outcomes in pediatric IM patients across 32 HCOs. The control group for comparison also came from TriNetX data and consisted of a general pediatric cohort from 92 HCOs, including the HCOs in the pediatric IM cohort. TriNetX maps International Classification of Diseases (ICD), Ninth Revision, Clinical Modification (CM) codes (ICD-9-CM) to ICD, Tenth Revision, CM codes (ICD-10-CM) and ICD-9-CM procedure codes (PCS) to ICD-10-PCS codes using General Equivalence Mappings.10 TriNetX presents medical outcomes for periods of time after a defined index event, such as a diagnosis or procedure. Table 1 provides the inclusion and exclusion criteria for determining the cohorts. Cohorts were matched using propensity score matching (1:1) based on sex, current age, race, and ethnicity. To measure gastrointestinal symptoms, ICD-10-CM codes for constipation, abdominal pain, nausea and vomiting, diarrhea, and gastro-esophageal reflux disease (GERD) were queried (see Table S1C for ICD-10 codes). We present descriptive statistics of demographic data before and after matching. Cells with fewer than 10 cases but more than 0 cases are automatically rounded up to 10. Mean is displayed for the current age. Percentages are displayed for categorical variables. Data analysis was performed at two time intervals after the index event to evaluate overall (from Years 1 to 5) and longer-term outcomes (from Years 3 to 5). Follow-up began at 1 year after operation to exclude symptoms that could be related to operative intervention and recovery. The cohorts are the same for both follow-up periods. The former identifies whether the patient had one or more of the gastrointestinal outcomes in the 1–5 years after the index event, whereas the latter captures whether the patient had one or more of the gastrointestinal outcomes 3–5 years after the index event. Rates of the gastrointestinal outcomes for those follow-up periods were compared between cohorts. Risk ratios (RRs) with 95% confidence intervals were calculated. Three hundred fifty-four pediatric patients with IM met the inclusion criteria; these patients were matched 1:1 to 354 general pediatric patients. Table S2 provides cohort demographic data before and after matching. Before matching, the cohorts differed in current age, race, and sex. After matching, there were no significant differences in socio-demographic variables between the cohorts. Table 2 compares the cohorts in terms of the gastrointestinal outcomes for different follow-up periods. Compared to the pediatric general cohort, the pediatri","journal":"Journal of Pediatric Gastroenterology and Nutrition","year":2025,"id":534632,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9646,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":435410,"name":"Sydney A. Martinez","orcid":"0000-0003-1226-7506","position":1,"is_corresponding":false},{"id":650349,"name":"Savas T. Tsikis","orcid":"0000-0001-7588-8372","position":2,"is_corresponding":false},{"id":468202,"name":"Mohammad A. Al‐Mamun","orcid":"0000-0001-9509-4414","position":3,"is_corresponding":false},{"id":84006,"name":"Katie E. Corcoran","orcid":"0000-0002-7948-5877","position":0,"is_corresponding":true}],"reference_count":12,"raw_metadata":null,"created_at":"2026-07-19T02:51:47.434742Z","pmid":"40899185","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}