Predictors of mortality after primary discharge from hospital in patients with esophageal atresia

Simple item page
dc.contributor.authorTan Tanny, S.P.
dc.contributor.authorFearon, E.
dc.contributor.authorHawley, A.
dc.contributor.authorBrooks, J.A.
dc.contributor.authorComella, A.
dc.contributor.authorHutson, J.M.
dc.contributor.authorTeague, W.J.
dc.contributor.authorPellicano, A.
dc.contributor.authorKing, S.K.
dc.date.issued2020
dc.description.abstractObjective: To describe esophageal atresia mortality rates and their associations in our cohort. Study design: Patients with esophageal atresia, managed at The Royal Children's Hospital, Melbourne (1980-2018), who subsequently died, were retrospectively identified from the prospective Nate Myers Oesophageal Atresia database. Data collected included patient and maternal demographics, vertebral anomalies, anorectal malformations, cardiovascular anomalies, tracheoesophageal fistula, renal anomalies, and limb defects (VACTERL) associations, mortality risk factors, and preoperative, operative, and postoperative findings. Mortality before discharge was defined as death during the initial admission. Results: A total of 88 of the 650 patients (13.5%) died during the study period; mortality before discharge occurred in 66 of the 88 (75.0%); mortality after discharge occurred in 22 of the 88 (25.0%). Common causes of mortality before discharge were palliation for respiratory anomalies (15/66 [22.7%]), associated syndromes (11/66 [16.7%]), and neurologic anomalies (10/66 [15.2%]). The most common syndrome leading to palliation was trisomy 18 (7/66 [10.6%]). Causes of mortality after discharge had available documentation for 17 of 22 patients (77.3%). Common causes were respiratory compromise (6/17 [35.3%]), sudden unexplained deaths (6/17 [35.3%]), and Fanconi anemia (2/17 [11.8%]). Of the patients discharged from hospital, 22 of 584 (3.8%) subsequently died. There was no statistical difference in VACTERL association between mortality before discharge (31/61 [50.8%]) and mortality after discharge (11/20 [55.0%]), nor in incidence of twins between mortality before discharge (8/56 [14.3%]) and mortality after discharge (2/18 [11.1%]). Conclusions: We identified predictors of mortality in patients with esophageal atresia in a large prospective cohort. Parents of children with esophageal atresia must be counselled appropriately as to the likelihood of death after discharge from hospital.
dc.description.statementofresponsibilitySharman P. Tan Tanny, Edward Fearon, Alisa Hawley, Jo-Anne Brooks, Assia Comella, John M. Hutson, Warwick J. Teague, Anastasia Pellicano and Sebastian K. King
dc.identifier.citationJournal of Pediatrics, 2020; 219:70-75
dc.identifier.doi10.1016/j.jpeds.2019.12.031
dc.identifier.issn0022-3476
dc.identifier.issn1097-6833
dc.identifier.orcidTeague, W.J. [0000-0003-4747-6025]
dc.identifier.urihttp://hdl.handle.net/2440/130345
dc.language.isoen
dc.publisherElsevier
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1168142
dc.rightsCrown Copyright © 2019 Published by Elsevier Inc. All rights reserved.
dc.source.urihttps://doi.org/10.1016/j.jpeds.2019.12.031
dc.subjectEsophageal atresia
dc.titlePredictors of mortality after primary discharge from hospital in patients with esophageal atresia
dc.typeJournal article
pubs.publication-statusPublished

Files

Collections

Medicine publications