Current Outcomes of Infants with Esophageal Atresia and Tracheoesophageal Fistula: A Multicenter Analysis
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Read the article on jpedsurg.org ↗Article · Feb 2022 · 1 min read
In brief
In brief
Multicenter study of 3,290 infants with EA/TEF shows 12.7% in-hospital mortality, with outcomes strongly influenced by birth weight and associated congenital anomalies. Lower birth weight and presence of cardiac anomalies significantly increase both mortality risk and hospital length of stay.
Written by the GCMD Library team from the article.
Objective
: This study aims to quantify mortality rates and hospital lengths of stay (LOS) in neonates with esophageal atresia and tracheoesophageal fistula (EA/TEF), and to characterize the effects of birth weight (BW) and associated congenital anomalies upon these.
Methods
: Data regarding patients with EA/TEF were prospectively collected (2013-2019) at 298 North American centers. The primary outcome was mortality and secondary outcome was LOS. Risk factors affecting mortality and LOS were assessed.
Results
: EA/TEF was diagnosed in 3290 infants with a median BW of 2476 g (IQR 1897,2970). In-hospital mortality was 12.7%. Mortality was inversely correlated with BW. After adjustment, the risk of mortality decreased by approximately 11% with every 100g increase in BW. A significant congenital anomaly other than EA/TEF was diagnosed in 37.9% of patients. Risk of mortality increased in patients with associated congenital anomalies, most notably in those with a severe cardiac anomaly. Lower BW was associated with an increased mean LOS among survivors. Similar to mortality risk, additional anomalies were associated with prolonged LOS.
Conclusions
: This study demonstrates an in-hospital mortality of over 10%. Both increased mortality and prolonged LOS are highly associated with lower birth weight and the presence of concomitant congenital anomalies.