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Moges N, Ahmed K, Birhanu D, Belege F, Dimtse A, Kerebeh G, Kassa BD, Geta K, Oumer KE, Zewde EA, Dessie AM, Anley DT, Demis S, GebreEyesus FA, Bantie B. Surgical outcome and predictors of neonates with esophageal atresia admitted at Tikur Anbesa Specialized Hospital. PLoS One 2023; 18:e0285669. [PMID: 37192197 DOI: 10.1371/journal.pone.0285669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 04/27/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) is the most common congenital anomaly of the esophagus. This anomaly continues to cause considerable morbidity and mortality in Sub-Saharan Africa, presenting various concerns about how to treat esophageal atresia. Esophageal atresia-related neonatal mortality can be reduced by evaluating the surgical outcome and identifying associated factors. OBJECTIVE This study aimed to assess the surgical outcome and identify predictors of neonates with esophageal atresia admitted at Tikur Anbesa specialized hospital. METHODS Retrospective crossectional study design was employed on 212 neonates with esophageal atresia who were undergone surgical intervention in Tikur Anbesa specialized hospital. Data were entered into epi data 4.6 and exported to Stata version 16 software for further analysis. A logistic regression model with Adjusted odds ratio (AOR), confidence interval (CI) and p-value <0.05 were used to identify predictors of poor surgical outcome of neonates with esophageal atresia. RESULT In this study, 25% of newborns who underwent surgical intervention at TikurAbnbesa specialized hospital had successful surgical outcomes, compared to 75% of neonates with esophageal atresia who had poor surgical outcomes. Significant predictors of the poor surgical outcome of neonates with esophageal atresia were severe thrombocytopenia (AOR = 2.81(1.07-7.34)), timing of surgery (AOR = 3.7(1.34-10.1), aspiration pneumonia (AOR = 2.93(1.17-7.38)) and related abnormalities (AOR = 2.26(1.06-4.82)). CONCLUSION The results of this study showed that, when compared to other studies, a substantial percentage of newborn children with esophageal atresia had poor surgical outcomes. Early surgical management, aspiration pneumonia and thrombocytopenia prevention and therapy play a big part in improving the surgical prognosis for newborns with esophageal atresia.
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Affiliation(s)
- Natnael Moges
- Department of Paediatrics and Child Health Nursing, Debretabor University, College of Health Science, Debre Tabor, Ethiopia
| | - Kassaye Ahmed
- Department of Neonatal Nursing, University of Gondar, College of Health Science, Gondar, Ethiopia
| | - Dires Birhanu
- Department of Paediatrics and Child Health Nursing, Dilla University, College of Health Science, Dilla, Ethiopia
| | - Fekadesellasie Belege
- Department of Paediatrics and Child Health Nursing, Wollo University, College of Health Science, School of Nursing and Midwifery, Dessie, Ethiopia
| | - Asrat Dimtse
- Department of Neonatology, Addis Ababa University, College of Health Science, School of Medicine, Addis Ababa, Ethiopia
| | - Gashaw Kerebeh
- Department of Paediatrics and Child Health Nursing, Debretabor University, College of Health Science, Debre Tabor, Ethiopia
| | - Belayneh Dessie Kassa
- Debretabor University, College of Health Science, School of medicine, DebreTabor, Ethiopia
| | - Kumlachew Geta
- Department of Aesthesia, Debretabor University, College of Health Science, Debretabor, Ethiopia
| | - Keder Essa Oumer
- Department of Aesthesia, Debretabor University, College of Health Science, Debretabor, Ethiopia
| | - Edgeit Abebe Zewde
- Department of Biomedical Science, Debretabor University, College of Health Science, Debretabor, Ethiopia
| | - Anteneh Mengist Dessie
- Department of Public Health, Debretabor University, College of Health Science, Debretabor, Ethiopia
| | - Denekew Tenaw Anley
- Department of Public Health, Debretabor University, College of Health Science, Debretabor, Ethiopia
| | - Solomon Demis
- Department of Paediatrics and Child Health Nursing, Debretabor University, College of Health Science, Debre Tabor, Ethiopia
| | - Fisha Alebel GebreEyesus
- Department of Department of Paediatrics and Child Health Nursing, Wolkite University, College of Medicine and Health Sciences, Wolkite, Ethiopia
| | - Berihun Bantie
- Department of Adult Health Nursing, Debretabor University, College of Health Science, Debretabor, Ethiopia
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Bronicki RA, Benitz WE, Buckley JR, Yarlagadda VV, Porta NFM, Agana DO, Kim M, Costello JM. Respiratory Care for Neonates With Congenital Heart Disease. Pediatrics 2022; 150:189881. [PMID: 36317970 DOI: 10.1542/peds.2022-056415h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/29/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- Ronald A Bronicki
- Baylor College of Medicine, Section of Critical Care Medicine and Cardiology, Texas Children's Hospital, Houston, Texas
| | - William E Benitz
- Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Lucile Packard Children's Hospital, Palo Alto, California
| | - Jason R Buckley
- Medical University of South Carolina, Divison of Pediatric Cardiology, Shawn Jenkins Children's Hospital, Charleston, South Carolina
| | - Vamsi V Yarlagadda
- Stanford School of Medicine, Division of Cardiology, Lucile Packard Children's Hospital, Palo Alto, California
| | - Nicolas F M Porta
- Northwestern University Feinberg School of Medicine, Division of Neonatology, Pediatric Pulmonary Hypertension Program, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Devon O Agana
- Mayo Clinic College of Medicine and Science, Department of Anesthesiology and Pediatric Critical Care Medicine, Mayo Eugenio Litta Children's Hospital, Rochester, Minnesota
| | - Minso Kim
- University of California San Francisco School of Medicine, Division of Critical Care, University of California San Francisco Benioff Children's Hospital, San Francisco, California
| | - John M Costello
- Medical University of South Carolina, Divison of Pediatric Cardiology, Shawn Jenkins Children's Hospital, Charleston, South Carolina
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Misganaw NM, Sebsbie G, Adimasu M, Getaneh FB, Arage G, GebreEyesus FA, Bayih WA, Chanie ES, Bantie B, Kerebeh G, Birhanu D, Jemere T, Mengist A, Kassaw A. Time to Death and Predictors Among Neonates with Esophageal Atresia in Ethiopia. J Multidiscip Healthc 2022; 15:1225-1235. [PMID: 35669446 PMCID: PMC9166279 DOI: 10.2147/jmdh.s366470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/20/2022] [Indexed: 12/23/2022] Open
Abstract
Background Esophageal atresia is an upper gastrointestinal tract developmental abnormality in which the upper and lower esophagus do not connect. Esophageal atresia has a higher incidence of death in sub-Saharan Africa, ranging from 30% to 80%. In Ethiopia, infants with esophageal atresia had a higher mortality rate. The assessment of time to death and predictors of esophageal atresia can help to reduce newborn mortality. Objective This study was aimed to investigate the time to death and predictors of neonates with esophageal atresia admitted to Tikur Anbessa Specialized Hospital, Ethiopia. Methods An institutional-based retrospective follow-up study was conducted among 225 neonates diagnosed with esophageal atresia. The median survival time, Kaplan–Meier failure estimation curve, and Log rank test were computed. Bivariable and multivariable Cox regression hazards models were fitted to identify the predictors of time to death. Hazard ratio with a 95% confidence interval was calculated and p-values <0.05 were considered statistically significant. Results In the study, the incidence density rate of neonates diagnosed with esophageal atresia was 5.5 (95% CI, 4.7–6.4) per 100-neonates day. The median time to death was 11 days (95% confidence interval (CI), 8.92–13.08). Birth weight <2500 g (adjusted hazard ratio (AHR)=1.49, 95% CI, 1.02 −2.21), having sepsis (AHR=1.67,95% CI, 1.15–2.44), being malnourished (AHR = 1.61, 95% CI, 1.03 −2.58), esophageal atretic neonates without surgery (AHR = 3.72, 95% CI, 1.34–10.38), diagnosis time at >48 hours of admission (AHR = 1.48, 95% CI, 1.01–2.15) and being dehydrated (AHR = 2.38, 95% CI, 1.63–3.46) were significant predictors of time to death among esophageal atretic neonates. Conclusion The findings in this study highlighted the necessity of early diagnosis, proper comorbidity treatment, and timely surgical intervention to reduce infant deaths due to esophageal atresia.
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Affiliation(s)
- Natnael Moges Misganaw
- Debre Tabor University, College of Health Science, Department of Paediatrics and Child Health Nursing, Debre Tabor, Ethiopia
- Correspondence: Natnael Moges Misganaw, Email
| | - Girum Sebsbie
- Addis Ababa University, College of Health Science, School of Nursing and Midwifery, Department of Paediatrics and Child Health Nursing, Addis Ababa, Ethiopia
| | - Mekonen Adimasu
- Addis Ababa University, College of Health Science, School of Nursing and Midwifery, Department of Paediatrics and Child Health Nursing, Addis Ababa, Ethiopia
| | - Fekadeselassie Belege Getaneh
- Wollo University, College of Health Science, School of Nursing and Midwifery, Department of Paediatrics and Child Health Nursing, Dessie, Ethiopia
| | - Getachew Arage
- Debre Tabor University, College of Health Science, Department of Paediatrics and Child Health Nursing, Debre Tabor, Ethiopia
| | - Fisha Alebel GebreEyesus
- Wolkite University, College of Medicine and Health Science, Department of Paediatrics and Child Health Nursing, Wolkite, Ethiopia
| | - Wubet Alebachew Bayih
- Debre Tabor University, College of Health Science, Department of Paediatrics and Child Health Nursing, Debre Tabor, Ethiopia
| | - Ermias Sisay Chanie
- Debre Tabor University, College of Health Science, Department of Paediatrics and Child Health Nursing, Debre Tabor, Ethiopia
| | - Berihun Bantie
- Debre Tabor University, College of Health Science, Department of Adult Health Nursing, Debre Tabor, Ethiopia
| | - Gashaw Kerebeh
- Debre Tabor University, College of Health Science, Department of Paediatrics and Child Health Nursing, Debre Tabor, Ethiopia
| | - Dires Birhanu
- Dilla University, College of Health Science, Department of Paediatrics and Child Health Nursing, Dilla, Ethiopia
| | - Tadeg Jemere
- Debre Tabor University, College of Health Science, Department of Biomedical Science, Debre Tabor, Ethiopia
| | - Anteneh Mengist
- Debre Tabor University, College of Health Science, Department of Public Health, Debre Tabor, Ethiopia
| | - Amare Kassaw
- Debre Tabor University, College of Health Science, Department of Paediatrics and Child Health Nursing, Debre Tabor, Ethiopia
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McTaggart LS, Pfost SS, Williams TP, Ramdas D, Rapp A, Pillai AS, Thaker HM, Radhakrishnan RS. Tracheal and esophageal atresia with trachea-esophageal fistula – A rare co-occurrence with high mortality. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2021. [DOI: 10.1016/j.epsc.2020.101718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Zaki M, Batikhe MY. Neonatal and infantile fistulas: spectrum of findings on conventional contrast imaging with surgical correlation. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2019. [DOI: 10.1186/s43055-019-0007-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Serel Arslan S, Demir N, Karaduman AA, Tanyel FC, Soyer T. Assessment of the Concerns of Caregivers of Children with Repaired Esophageal Atresia-Tracheoesophageal Fistula Related to Feeding-Swallowing Difficulties. Dysphagia 2019; 35:438-442. [PMID: 31410568 DOI: 10.1007/s00455-019-10046-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 07/03/2019] [Accepted: 08/02/2019] [Indexed: 12/22/2022]
Abstract
The study aimed to assess concerns of caregivers of children with EA-TEF related to feeding-swallowing difficulties, compare the concerns according to type of atresia and repair time, and investigate its relationship with time to start oral feeding. Caregivers accompanying 64 children with EA-TEF were included. Age, sex, type of atresia, repair time, and time to start oral feeding were noted. Parents completed the Turkish version of the Feeding/Swallowing Impact Survey (T-FS-IS) to assess the concerns of caregivers related to feeding-swallowing difficulties. The T-FS-IS has three subscales including daily activities, worry, and feeding difficulties. The median age of patients was 3 (min = 1, max = 12) years, of which 57.8% were male. 43.8% of cases were isolated-EA, and 56.3% were EA-distal TEF. 57.8% of cases received early repair, and 42.2% had delayed repair. The median time to start oral feeding was 4 weeks (min = 1, max = 128). The mean scores of daily activities, worry, feeding difficulties, and total score from the T-FS-IS were 2.43 ± 1.18, 2.73 ± 1.28, 2.10 ± 0.97, and 2.44 ± 1.09, respectively. Caregivers of children with isolated-EA reported more problems in total score and all subscales of the T-FS-IS than EA-distal TEF (p < 0.01). Caregivers of children who received delayed repair reported more problems in total score and all subscales of the T-FS-IS than children with early repair (p < 0.05). Moderate to strong correlations were found between the T-FS-IS and time to start oral feeding (p < 0.01, r = 0.55-0.65). This study suggests that caregivers of children with isolated-EA and/or delayed repair and/or delay in oral intake may have higher concerns related to feeding-swallowing difficulties.
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Affiliation(s)
- Selen Serel Arslan
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Altındağ, 06100, Ankara, Turkey.
| | - Numan Demir
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Altındağ, 06100, Ankara, Turkey
| | - Aynur Ayşe Karaduman
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Altındağ, 06100, Ankara, Turkey
| | - Feridun Cahit Tanyel
- Department of Pediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Tutku Soyer
- Department of Pediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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