WFRF:(Svensson Linus)
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Postoperative morbidity and health-related quality of life in children with delayed reconstruction of esophageal atresia: a nationwide Swedish study
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- Dellenmark-Blom, Michaela, 1983 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics,Gothenburg Univ, Queen Silvia Childrens Hosp, Inst Clin Sci, Dept Pediat, S-41685 Gothenburg, Sweden.,Queen Silvia Children’s Hospital
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- Örnö Ax, Sofie (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics,Gothenburg Univ, Queen Silvia Childrens Hosp, Inst Clin Sci, Dept Pediat, S-41685 Gothenburg, Sweden.;Sahlgrens Univ Hosp, Queen Silvia Childrens Hosp, Dept Pediat Surg, Gothenburg, Sweden.,Queen Silvia Children’s Hospital
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- Ost, E. (författare)
- Karolinska Institute,Karolinska University Hospital
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- (creator_code:org_t)
- 2022-06-20
- 2022
- Engelska.
- Ingår i: Orphanet Journal of Rare Diseases. - : Springer Science and Business Media LLC. - 1750-1172. ; 17:1
- Tidskriftsartikel (refereegranskat)
Abstract
Ämnesord
Stäng
- Background In 10-15% of children with esophageal atresia (EA) delayed reconstruction of esophageal atresia (DREA) is necessary due to long-gap EA and/or prematurity/low birth weight. They represent a patient subgroup with high risk of complications. We aimed to evaluate postoperative morbidity and health-related quality of life (HRQOL) in a Swedish national cohort of children with DREA. Methods Postoperative morbidity, age-specific generic HRQOL (PedsQL((TM)) 4.0) and condition-specific HRQOL (The EA-QOL questionnaires) in children with DREA were compared with children with EA who had primary anastomosis (PA). Factors associated with the DREA group's HRQOL scores were analyzed using Mann-Whitney U-test and Spearman's rho. Clinical data was extracted from the medical records. Significance level was p < 0.05. Results Thirty-four out of 45 families of children with DREA were included and 30 returned the questionnaires(n = 8 children aged 2-7 years; n = 22 children aged 8-18 years). Compared to children with PA(42 children aged 2-7 years; 64 children aged 8-18 years), there were no significant differences in most early postoperative complications. At follow-up, symptom prevalence in children aged 2-7 with DREA ranged from 37.5% (heartburn) to 75% (cough). Further digestive and respiratory symptoms were present in >= 50%. In children aged 8-18, it ranged from 14.3% (vomiting) to 40.9% (cough), with other digestive and airway symptoms present in 19.0-27.3%. Except for chest tightness (2-7 years), there were no significant differences in symptom prevalence between children with DREA and PA, nor between their generic or condition-specific HRQOL scores (p > 0.05). More children with DREA underwent esophageal dilatations (both age groups), gastrostomy feeding (2-7 years), and antireflux treatment (8-18 years), p < 0.05. Days to hospital discharge after EA repair and a number of associated anomalies showed a strong negative correlation with HRQOL scores (2-7 years). Presence of cough, airway infection, swallowing difficulties and heartburn were associated with lower HRQOL scores (8-18 years), p < 0.05. Conclusions Although children with DREA need more treatments, they are not a risk group for postoperative morbidity and impaired HRQOL compared with children with PA. However, those with a long initial hospital stay, several associated anomalies and digestive or respiratory symptoms risk worse HRQOL. This is important information for clinical practice, families and patient stakeholders.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- Esophageal atresia
- Long-gap esophageal atresia
- Health-related quality
- of life
- Delayed reconstruction
- Long-term morbidity
- Postoperative
- outcomes
- birth-weight infants
- primary repair
- atresia/tracheoesophageal fistula
- adolescents born
- risk-factors
- gap
- replacement
- elongation
- experience
- anomalies
- Genetics & Heredity
- Research & Experimental Medicine
- Esophageal atresia
- Health-related quality of life
- Postoperative outcomes
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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