Esophageal Atresia and Respiratory Morbidity.


Journal

Pediatrics
ISSN: 1098-4275
Titre abrégé: Pediatrics
Pays: United States
ID NLM: 0376422

Informations de publication

Date de publication:
09 2021
Historique:
accepted: 31 03 2021
pubmed: 21 8 2021
medline: 21 10 2021
entrez: 20 8 2021
Statut: ppublish

Résumé

Respiratory diseases are common in children with esophageal atresia (EA), leading to increased morbidity and mortality in the first year. The primary study objective was to identify the factors associated with readmissions for respiratory causes in the first year in EA children. A population-based study. We included all children born between 2008 and 2016 with available data and analyzed factors at birth and 1 year follow-up. Factors with a Among 1460 patients born with EA, 97 (7%) were deceased before the age of 1 year, and follow-up data were available for 1287 patients, who constituted our study population. EAs were Ladd classification type III or IV in 89%, preterm birth was observed in 38%, and associated malformations were observed in 52%. Collectively, 61% were readmitted after initial discharge in the first year, 31% for a respiratory cause. Among these, respiratory infections occurred in 64%, and 35% received a respiratory treatment. In logistic regression models, factors associated with readmission for a respiratory cause were recurrence of tracheoesophageal fistula, aortopexy, antireflux surgery, and tube feeding; factors associated with respiratory treatment were male sex and laryngeal cleft. Respiratory morbidity in the first year after EA repair is frequent, accounting for >50% of readmissions. Identifying high risk groups of EA patients (ie, those with chronic aspiration, anomalies of the respiratory tract, and need for tube feeding) may guide follow-up strategies.

Sections du résumé

BACKGROUND AND OBJECTIVES
Respiratory diseases are common in children with esophageal atresia (EA), leading to increased morbidity and mortality in the first year. The primary study objective was to identify the factors associated with readmissions for respiratory causes in the first year in EA children.
METHODS
A population-based study. We included all children born between 2008 and 2016 with available data and analyzed factors at birth and 1 year follow-up. Factors with a
RESULTS
Among 1460 patients born with EA, 97 (7%) were deceased before the age of 1 year, and follow-up data were available for 1287 patients, who constituted our study population. EAs were Ladd classification type III or IV in 89%, preterm birth was observed in 38%, and associated malformations were observed in 52%. Collectively, 61% were readmitted after initial discharge in the first year, 31% for a respiratory cause. Among these, respiratory infections occurred in 64%, and 35% received a respiratory treatment. In logistic regression models, factors associated with readmission for a respiratory cause were recurrence of tracheoesophageal fistula, aortopexy, antireflux surgery, and tube feeding; factors associated with respiratory treatment were male sex and laryngeal cleft.
CONCLUSIONS
Respiratory morbidity in the first year after EA repair is frequent, accounting for >50% of readmissions. Identifying high risk groups of EA patients (ie, those with chronic aspiration, anomalies of the respiratory tract, and need for tube feeding) may guide follow-up strategies.

Identifiants

pubmed: 34413249
pii: peds.2020-049778
doi: 10.1542/peds.2020-049778
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT02883725']

Types de publication

Journal Article Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2021 by the American Academy of Pediatrics.

Déclaration de conflit d'intérêts

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Auteurs

Stéphanie Lejeune (S)

Reference Center for Chronic Esophageal Anomalies, Reference Center for Rare Esophageal Diseases, INFINITE Lille stephanie.lejeune@chru-lille.fr.

Rony Sfeir (R)

Reference Center for Chronic Esophageal Anomalies, Reference Center for Rare Esophageal Diseases, INFINITE Lille.

Véronique Rousseau (V)

University Hospital Necker Enfants Malades, Paris, France.

Arnaud Bonnard (A)

University Hospital Robert Debré, Paris, France.

Thomas Gelas (T)

University Hospital of Lyon, Lyon, France.

Madeleine Aumar (M)

Reference Center for Chronic Esophageal Anomalies, Reference Center for Rare Esophageal Diseases, INFINITE Lille.

Nicoleta Panait (N)

University Hospital of Marseille, Marseille, France.

Pierre-Yves Rabattu (PY)

University Hospital of Grenoble Alpes, Grenoble, France.

Sabine Irtan (S)

University Hospital Armand Trousseau, Paris-Sorbonne Universités, Université Pierre et Marie Curie-Paris 6, Centre de Recherche St Antoine Inserm UMRS.938, Paris, France.

Virginie Fouquet (V)

University Hospital of Kremlin Bicetre, Paris, France.

Aurélie Le Mandat (A)

University Hospital of Toulouse, Toulouse, France.

Stephan De Napoli Cocci (SN)

University Hospital of Nantes, Nantes, France.

Edouard Habonimana (E)

University Hospital of Rennes, Rennes, France.

Thierry Lamireau (T)

University Hospital of Bordeaux, Bordeaux, France.

Jean-Louis Lemelle (JL)

University Hospital of Nancy, Nancy, France.

Frédéric Elbaz (F)

University Hospital of Rouen, Rouen, France.

Isabelle Talon (I)

University Hospital of Strasbourg, Strasbourg, France.

Nadia Boudaoud (N)

University Hospital of Reims, Reims, France.

Hossein Allal (H)

University Hospital of Montpellier, Montpellier, France.

Philippe Buisson (P)

University Hospital of Amiens, Amiens, France.

Thierry Petit (T)

University Hospital of Caen, Caen, France.

Emmanuel Sapin (E)

University Hospital of Dijon, Dijon, France.

Hubert Lardy (H)

University Hospital of Tours, Tours, France.

Françoise Schmitt (F)

University Hospital of Angers, Angers, France.

Guillaume Levard (G)

University Hospital of Poitiers, Poitiers, France.

Aurélien Scalabre (A)

University Hospital of St Etienne, Saint-Priest-en-Jarez, France.

Jean-Luc Michel (JL)

University Hospital of La Reunion, Reunion Island, France.

Olivier Jaby (O)

University Hospital of Créteil, Créteil, France.

Cécile Pelatan (C)

General Hospital of Le Mans, Le Mans, France.

Philine De Vries (P)

University Hospital of Brest, Brest, France.

Corinne Borderon (C)

University Hospital of Clermont-Ferrand, Clermont-Ferrand, France.

Laurent Fourcade (L)

University Hospital of Limoges, Limoges, France.

Jean Breaud (J)

University Hospital of Nice, Nice, France.

Myriam Arnould (M)

General Hospital of Orléans, Orléans, France.

Cécilia Tolg (C)

University Hospital of Fort de France, Martinique, France.

Yann Chaussy (Y)

University Hospital of Besançon, Besançon, France.

Stephan Geiss (S)

General Hospital of Colmar, Colmar, France.

Christophe Laplace (C)

University Hospital of Point à Pître, Guadeloupe, France.

Elodie Drumez (E)

METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales.
Department of Biostatistics, Centre Hospitalier Universitaire de Lille, University Lille, Lille, France.

Sawsan El Mourad (S)

Reference Center for Chronic Esophageal Anomalies, Reference Center for Rare Esophageal Diseases, INFINITE Lille.
General Hospital of Arras, Arras, France.

Caroline Thumerelle (C)

Reference Center for Chronic Esophageal Anomalies, Reference Center for Rare Esophageal Diseases, INFINITE Lille.

Frédéric Gottrand (F)

Reference Center for Chronic Esophageal Anomalies, Reference Center for Rare Esophageal Diseases, INFINITE Lille.

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