Predictors of index admission mortality and morbidity in contemporary esophageal atresia patients

Lazow, Stefanie P.; Ben-Ishay, Offir; Aribindi, Vamsi; Staffa, Steven J.; Pluchinotta, Francesca R; Schecter, Samuel C.; Cauley, Ryan; Tworetzky, Wayne; Lee, Hanmin; Moon-Grady, Anita J.; Buchmiller, Terry L.

doi:10.1016/j.jpedsurg.2020.02.005

Cited by 19 publications

(18 citation statements)

References 24 publications

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“…Level A Recommendations Recommendation 23: A negative CXR does not rule out the presence of bronchiectasis R Level C Recommendations Recommendation26: CXR should be obtained annually in all children with TEF regardles Bronchiectasis is defined as an abnormal dilatation of the bronchial tree and it is one of the more serious pulmonary compli Intermittent acute profound cyanosis in patients with EA-TEF is usually due to near complete collapse of the trachea. However, the possibility of an anatomical shunt has to be ruled out because congenital heart malformations associated with right-to-left shunts (such as valve atresia, Tetralogy of Fallot, anomalous pulmonary venous return, and septal defects or patent ductus arteriosus) are present in more than one quarter of the patients 80,84 and they are independent predictors of survival 125 . For children with no history of congenital heart disease an echocardiogram is useful in order to investigate for presence of vascular abnormalities such as right-sided or double aortic arch, and aberrant right or left subclavian arteries that may complicate the clinical presentation by causing or exacerbating the degree of tracheomalacia 37,78,80,81,126 .…”

Section: Evaluation Of Bronchiectasismentioning

confidence: 99%

Care Recommendations for the Respiratory Complications of Esophageal Atresia-Tracheoesophageal Fistula: The International Network of Esophageal Atresia, Respiratory Complications Working Group

Koumbourlis

Belessis

Cataletto

et al. 2020

Preprint

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Tracheoesophageal fistula (TEF) with esophageal atresia (EA) is a common congenital anomaly that is associated with significant respiratory morbidity throughout life. The objective of this document is to provide a framework for the diagnosis and management of the respiratory complications that are associated with the condition. As there are no randomized controlled studies on the subject, a group of experts used a modification of the Rand Appropriateness Method to describe the various aspects of the condition in terms of their relative importance, and to rate the available diagnostic methods and therapeutic interventions on the basis of their appropriateness and necessity. Specific recommendations were formulated and reported as Level A, B, C based on whether they were based on "strong", "moderate" or "weak" agreement. The tracheomalacia that exists in the site of the fistula was considered the main abnormality that predisposes to all other respiratory complications due to airway collapse and impaired clearance of secretions. Aspiration due to impaired airway protection reflexes is the main underlying contributing mechanism. Flexible bronchoscopy is the main diagnostic modality, aided by imaging modalities, especially CT scans of the chest. Non-invasive positive airway pressure support, surgical techniques such as tracheopexy and rarely tracheostomy are required for the management of severe tracheomalacia. Regular long-term follow-up by a multidisciplinary team was considered imperative. Specific templates outlining the elements of the clinical respiratory evaluation according to the patients' age were also developed.

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Section: Evaluation Of Bronchiectasismentioning

confidence: 99%

Care Recommendations for the Respiratory Complications of Esophageal Atresia-Tracheoesophageal Fistula: The International Network of Esophageal Atresia, Respiratory Complications Working Group

Koumbourlis

Belessis

Cataletto

et al. 2020

Preprint

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“…So far, little is known about gender-specific aspects of EA. New evidence suggests that male gender might be considered a risk factor for increased morbidity and even mortality 12 in EA patients, or incidence of congenital malformation in general. 13 In our study, male infants had significantly more esophageal procedures than females.…”

Section: Discussionmentioning

confidence: 99%

Esophageal Interventions in Infants Born with Esophageal Atresia: A Comprehensive Analysis of a National Database

et al. 2021

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Introduction Esophageal atresia (EA) is a rare malformation that often requires a series of procedures, including surgical primary anastomosis, staged repair, and endoscopic procedures. Actual numbers and trends in interventions and variety in treatment strategies remain unclear. Materials and Methods Data from the German federal bureau of statistics containing all EA-related inpatient procedures encoded from 2005 until 2018 were analyzed for children during the first year of life. The sum of esophageal anastomoses and replacements was used to calculate an estimate of incidence of EA. Results Over 14 years, 12,627,888 inpatient cases were recorded in infants in Germany. The mean incidence of EA was 1 per 4,217 live births. On average, 163.3 (95% confidence interval [CI]: 150.8–176.1) esophageal anastomoses, 11.2 (95% CI: 8.7–13.7) esophageal lengthening procedures, and 6.7 (95% CI: 5.42–8.00) esophageal replacements were recorded annually. Overall, 187.8 (95% CI: 147.1–200.4) endoluminal treatments (ballon dilatation, bougienage, stent placement, or injection) were performed per 100 anastomoses. Over the years, bougienage was increasingly replaced by ballon dilatation as primary treatment. Boys had a significantly higher number of esophageal procedures than girls, but the incidence of endoscopic treatments in relation to anastomoses was the same for both genders. Conclusion The low incidence of EA in relation to a relatively large number of units treating those patients in Germany may pose challenges for maintaining competency and training of all specialists involved. The number of esophagoscopic treatments for esophageal stricture per anastomosis is lower than previously estimated.

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“…Classification According to Other accompanying disorders. Spitz's classification of safety in esophageal atresia: Group I: birth weight> 1500 g without major heart defects (major); Group II: birth weight <1500 g or with major heart defects; Group III: birth weight <1500 g and major heart defects [25] .…”

Section: ~ 92 ~mentioning

confidence: 99%

Prevalence of esophageal atresia as well as Mortality Outcomes based on Prognostic Criteria at Tarakan General Hospital from 2015 To 2021

Gaol¹,

Firmansyah²,

Anita³

2021

Int. J. Surg. Sci.

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Esophageal atresia (EA) is a disorder that often occurs in infants with an incidence in the world ranging from 0.4 -3.6 per 10,000 births. The survival rate in developed countries ranges from 85 to 95%. The causes of EA mortality in infants vary widely. The purpose of this study was to see the risk factors for the incidence of EA mortality in infants and the prevalence of EA from all operations in the pediatric surgery division at Tarakan Hospital. Method and Material: Cross sectional study with research samples in the form

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Predictors of index admission mortality and morbidity in contemporary esophageal atresia patients

Cited by 19 publications

References 24 publications

Care Recommendations for the Respiratory Complications of Esophageal Atresia-Tracheoesophageal Fistula: The International Network of Esophageal Atresia, Respiratory Complications Working Group

Care Recommendations for the Respiratory Complications of Esophageal Atresia-Tracheoesophageal Fistula: The International Network of Esophageal Atresia, Respiratory Complications Working Group

Esophageal Interventions in Infants Born with Esophageal Atresia: A Comprehensive Analysis of a National Database

Prevalence of esophageal atresia as well as Mortality Outcomes based on Prognostic Criteria at Tarakan General Hospital from 2015 To 2021

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