Rony Sfeir1, Veronique Rousseau2, Arnaud Bonnard3, Thomas Gelas4, Madeleine Aumar5, Nicoleta Panait6, Christian Piolat7, Sabine Irtan8, Virginie Fouquet9, Aurelie Lemandat10, Stephan De Napoli11, Edouard Habonimana12, Thierry Lamireau13, Jean Louis Lemelle14, Frederic El Baz15, Isabelle Talon16, Marie Laurence Polimerol17, Hussein Allal18, Philippe Buisson19, Thierry Petit20, David Louis21, Hubert Lardy22, Francoise Schmitt23, Guillaume Levard24, Aurélien Scalabre25, Jean Luc Michel26, Olivier Jaby27, Cecile Pelatan28, Philine De Vries29, Corinne Borderon30, Laurent Fourcade31, Jean Breaud32, Myriam Pouzac33, Cecilia Tolg34, Yann Chaussy35, Sandy Jochault Ritz36, Christophe Laplace37, Elodie Drumez38, Frederic Gottrand5. 1. University of Lille, CHU Lille, INSERM U1286, Centre de référence des affections chroniques et malformatives de l'œsophage, Lille, France. Electronic address: rony.sfeir@chru-lille.fr. 2. University Hospital of Necker Enfants Malades Paris, France. 3. University hospital of Robert Debre, Paris, France. 4. University Hospital of Lyon, France. 5. University of Lille, CHU Lille, INSERM U1286, Centre de référence des affections chroniques et malformatives de l'œsophage, Lille, France. 6. University Hospital of Marseille, France. 7. University Hospital of Grenoble, France. 8. University Hospital of Trousseau Paris, France. 9. University Hospital of Kremlin Bicetre, Paris, France. 10. University Hospital of Toulouse, France. 11. University Hospital of Nantes, France. 12. University Hospital of Rennes, France. 13. University Hospital Bordeaux, France. 14. University Hospital of Nancy, France. 15. University Hospital of Rouen, France. 16. University Hospital of Starsbourg, France. 17. University Hospital of Reims, France. 18. University Hospital of Montpellier, France. 19. University Hospital of Amiens, France. 20. University Hospital of Caen, France. 21. University Hospital of Dijon, France. 22. University Hospital of Tours, France. 23. University Hospital of Angers, France. 24. University Hospital of Poitiers, France. 25. University Hospital of Saint Etienne, France. 26. University Hospital of La Reunion, France. 27. General Hospital of Creteil, France. 28. General Hospital of Le Mans, France. 29. University Hospital of Brest, France. 30. University Hospital of Clermont Ferrand, France. 31. University Hospital of Limoges, France. 32. University Hospital of Nice, France. 33. General Hospital of Orleans, France. 34. University Hospital of Martinique, France. 35. University Hospital of Besancon, France. 36. General Hospital of Colmar, France. 37. University Hospital of Guadeloupe, France. 38. University of Lille, CHU Lille, Évaluation des technologies de santé et des pratiques médicales, Lille, France.
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.
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.
Authors: Erwin Brosens; Rutger W W Brouwer; Hannie Douben; Yolande van Bever; Alice S Brooks; Rene M H Wijnen; Wilfred F J van IJcken; Dick Tibboel; Robbert J Rottier; Annelies de Klein Journal: Genes (Basel) Date: 2021-10-10 Impact factor: 4.096