Comorbidities and course of lung function in patients with congenital esophageal atresia

Abstract

Objective. To describe the epidemiological characteristics, hospital follow-up, and course of patients who underwent surgery for esophageal atresia and its consequences on lung function. Population and methods. Retrospective, longitudinal, and analytical study. The medical records of patients with esophageal atresia born between 1996 and 2017 were reviewed. Perinatal data, type of atresia, associated malformations, respiratory and gastrointestinal complications, and spirometry data were recorded over 3 years. Results. A total of 97 patients were included. The most common type of atresia was III, and the most frequent syndrome, trisomy 21; 13.4 % of patients died in the neonatal period; 23.8 % were followed up by the Department of Pulmonology, and their respiratory complications included exacerbations (46.4 %), wheezing or asthma (36 %), and pneumonia (26.8 %). Gastroesophageal reflux was a risk factor for wheezing (OR: 5.31; p = 0.002), exacerbations (OR: 4.00; p = 0.009), and pneumonia (OR: 3.24; p = 0.02). In the first spirometry (n = 20), the pattern was normal in 65 %; restrictive in 30 %; and mixed in 5 %. In the second spirometry (n = 19), the pattern was normal in 42.1 %; restrictive in 31.6 %; obstructive in 15.8 %, and mixed in 10.5 %. In the third spirometry (n = 14), the pattern was normal in 50 %; restrictive in 21.4 %; obstructive in 14.3 %, and mixed in 14.3 %. Conclusions. In our sample of patients, a large proportion had respiratory and gastrointestinal comorbidities. Lung function worsened progressively.

Patient-Reported Outcome Measures and Clinical Outcomes in Children with Foregut Anomalies

“…The general disagreement between clinical outcomes and a child’s own experiences found in our study indicates that identification of long-term morbidities cannot be based solely on PROMs for HS and QoL. Given that clinical outcomes tend to deteriorate with age in children born with foregut anomalies [ 14 , 28 , 29 ], the importance of routinely measuring clinical outcomes becomes more apparent, as it allows for early identification of children at risk of declining performance. This should be communicated clearly to both children and their caregivers in order to support a discussion about the added value of complying to a timely intervention when problems arise.…”