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Pediatric Surgery International
Published in: Pediatric Surgery International 10/2018

01-10-2018 | Original Article

New prognostic classification and managements in infants with esophageal atresia

Authors: Masaya Yamoto, Akiyoshi Nomura, Koji Fukumoto, Toshiaki Takahashi, Kengo Nakaya, Akinori Sekioka, Yutaka Yamada, Naoto Urushihara

Published in: Pediatric Surgery International | Issue 10/2018

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Abstract

Purpose

The aim of this study was to investigate the risk factors for in hospital mortality in infants with esophageal atresia (EA) without critical chromosome abnormality disorders and develop a new prognostic classification to assess the influence of external risk factors on the prognosis of EA, which could provide more effective treatment strategies in clinical practice.

Methods

A retrospective chart review of all consecutive patients between January 1994 and December 2017, which included 65 EA infants who were admitted to Shizuoka Children’s Hospital, was conducted. Based on multivariate analysis data and ROC analysis, the discrimination of the new prognostic classification was quantified and compared with that of the Spitz classification using the area under the ROC curve (AUC).

Results

Multiple logistic regression analysis showed that birth weight of < 1606 g (adjusted OR, 13.16; 95% CI, 1.16–352.75), and complex cardiac anomalies (adjusted OR 22.39; 95% CI 2.45–569.14) were significant risk factors for death. We have created a new classification close to Spitz classification using the presence of complex cardiac anomalies and birth weight. The mortality rates were 0% for class I (n = 0/40), 7.1% for class II (n = 1/14), 33.3% for class III (n = 3/9), and 100% for class IV (n = 2/2). The AUC of the new classification was better than that of the Spitz classification (0.939 vs 0.812, respectively; p = 0.04).

Conclusion

New prognostic classification can improve the stratification of EA patients and be a useful predictor of survival.
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Metadata
Title
New prognostic classification and managements in infants with esophageal atresia
Authors
Masaya Yamoto
Akiyoshi Nomura
Koji Fukumoto
Toshiaki Takahashi
Kengo Nakaya
Akinori Sekioka
Yutaka Yamada
Naoto Urushihara
Publication date
01-10-2018
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 10/2018
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-018-4322-5

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