{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T06:02:53Z","timestamp":1785132173695,"version":"3.55.0"},"reference-count":44,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the impact of social determinants of health (SDOH) on outcomes in pediatric short bowel syndrome (SBS) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort of SBS children managed by an Intestinal Rehabilitation Program was analyzed. Socio\u2010economic variables including income, race, distance to hospital, parental education and immigrant status were chosen to assess whether they independently predicted the following outcomes: enteral autonomy (EA), central line associated blood stream infection (CLABSI), intestinal failure associated liver disease (IFALD), and mortality. Bowel anatomy, prematurity, and disease type were controlled for. Univariate analysis and Cox proportional hazards model (CPH) were performed, where an alpha\u2010value of &lt;0.05 was significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 161 patients were analyzed between 2006 and 2019. The median gestational age was 34 (29.0\u201337.0) weeks and 61.9% were male. EA was achieved in 63.5%, 22.5% developed IFALD, and 10% died. The median CLABSI rate was 4.0 (0.4\u201311.1) per 1000 catheter days. CPH modeling revealed that the only social factor positively associated with attaining EA was non\u2010white race (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). Parental post\u2010secondary education was associated with a lower risk of CLABSI (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04) while those living larger distances from hospital had an increased risk (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). The development of IFALD was also positively associated with greater distance from hospital (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Mortality was positively associated with both having an immigrant background (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04), non\u2010white race (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03) and having a parent with post\u2010secondary education (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although clinical factors such as anatomy and diagnosis predict prognosis in SBS, social determinants also influence outcomes and should be considered in the support of families.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jpn3.70420","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T06:01:29Z","timestamp":1774936889000},"page":"14-20","source":"Crossref","is-referenced-by-count":0,"title":["Impact of social determinants of health on outcomes in pediatric short bowel syndrome"],"prefix":"10.1002","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9700-3272","authenticated-orcid":false,"given":"Justyna Maria","family":"Wolinska","sequence":"first","affiliation":[{"name":"Children's Hospital of Eastern Ontario Ottawa Ontario Canada"},{"name":"University of Ottawa Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Belza","sequence":"additional","affiliation":[{"name":"Hospital for Sick Children Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul William","family":"Wales","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center Cincinnati Ohio USA"},{"name":"University of Cincinnati Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mco.0000222116.68912.fc"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2004.01.036"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2012.03.062"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2005.01.037"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2022.05.049"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2018.06.981"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2021.06.025"},{"key":"e_1_2_7_9_1","unstructured":"Social Determinants of Health\u2014Healthy People 2030; 2024. 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