2021 · JOURNAL OF PEDIATRICS

Risk Factors of Early Mortality and Morbidity in Esophageal Atresia with Distal Tracheoesophageal Fistula: A Population-Based Cohort Study

Sfeir, Rony, Rousseau, Veronique, Bonnard, Arnaud, Gelas, Thomas, Aumar, Madeleine, Panait, Nicoleta, Piolat, Christian, Irtan, Sabine, Fouquet, Virginie, Lemandat, Aurelie, De Napoli, Stephan, Habonimana, Edouard, Lamireau, Thierry, Lemelle, Jean Louis, El Baz, Frederic, Talon, Isabelle, Polimerol, Marie Laurence, Allal, Hussein, Buisson, Philippe, Petit, Thierry, Louis, David, Lardy, Hubert, Schmitt, Francoise, Levard, Guillaume, Scalabre, Aurelien, Michel, Jean Luc, Jaby, Olivier, Pelatan, Cecile, De Vries, Philine, Borderon, Corinne, Fourcade, Laurent, Breaud, Jean, Pouzac, Myriam, Tolg, Cecilia, Chaussy, Yann, Ritz, Sandy Jochault, Laplace, Christophe, Drumez, Elodie, Gottrand, Frederic

Journal: JOURNAL OF PEDIATRICS
Année: 2021
Volume: 234
Pages: 99+
Mois: JUL
DOI: 10.1016/j.jpeds.2021.02.064

Abstract

Objective To identify the risk factors for early mortality and morbidity in a population with distal esophageal atresia (EA)-tracheoesophageal fistula. Study design Cohort study from a national register. Main outcomes and measures included early mortality, hospital length of stay (LoS), need for nutritional support at 1 year of age as a proxy measure of morbidity, and complications during the first year of life. Results In total, 1008 patients with a lower esophageal fistula were included from January 1, 2008, to December 31, 2014. The survival rate at 3 months was 94.9%. The cumulative hospital LoS was 31.0 (17.0-64.0) days. Multivariate analysis showed that intrahospital mortality at 3 months was associated with low birth weight (OR 0.52, 95% CI [0.38-0.72], P <.001), associated cardiac abnormalities (OR 6.09 [1.96-18.89], P =.002), and prenatal diagnosis (OR 2.96 [1.08-8.08], P =.034). LoS was associated with low birth weight (-0.225 +/- 0.035, P <.001), associated malformations (0.082 +/- 0.118, P <.001), surgical difficulties (0.270 +/- 0.107, P <.001), and complications (0.535 +/- 0.099, P <.001) during the first year of life. Predictive factors for dependency on nutrition support at 1 year of age were complications before 1 year (OR 3.28 [1.23-8.76], P < .02) and initial hospital LoS (OR 1.96 [1.15-3.33], P <.01). Conclusions EA has a low rate of early mortality, but morbidity is high during the first year of life. Identifying factors associated with morbidity may help to improve neonatal care of this population.

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