Postoperative morbidity and health-related quality of life in children with delayed reconstruction of esophageal atresia: a nationwide Swedish study. Dellenmark-Blom, M., Örnö Ax, S., Öst, E., Svensson, J. F., Kassa, A., Jönsson, L., Abrahamsson, K., Gatzinsky, V., Stenström, P., Tollne, A., Omling, E., & Engstrand Lilja, H. Orphanet Journal of Rare Diseases, 17(1):239, June, 2022. doi abstract bibtex 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™ 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 \textless 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 \textgreater 0.05). More children with DREA underwent esophageal dilatations (both age groups), gastrostomy feeding (2-7 years), and antireflux treatment (8-18 years), p \textless 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 \textless 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.
@article{dellenmark-blom_postoperative_2022,
title = {Postoperative morbidity and health-related quality of life in children with delayed reconstruction of esophageal atresia: a nationwide {Swedish} study},
volume = {17},
issn = {1750-1172},
shorttitle = {Postoperative morbidity and health-related quality of life in children with delayed reconstruction of esophageal atresia},
doi = {10.1186/s13023-022-02381-y},
abstract = {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™ 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 {\textless} 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 {\textgreater} 0.05). More children with DREA underwent esophageal dilatations (both age groups), gastrostomy feeding (2-7 years), and antireflux treatment (8-18 years), p {\textless} 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 {\textless} 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.},
language = {eng},
number = {1},
journal = {Orphanet Journal of Rare Diseases},
author = {Dellenmark-Blom, Michaela and Örnö Ax, Sofie and Öst, Elin and Svensson, Jan F. and Kassa, Ann-Marie and Jönsson, Linus and Abrahamsson, Kate and Gatzinsky, Vladimir and Stenström, Pernilla and Tollne, AnnaMaria and Omling, Erik and Engstrand Lilja, Helene},
month = jun,
year = {2022},
keywords = {Child, Cough, Delayed reconstruction, Esophageal Atresia, Esophageal atresia, Health-related quality of life, Heartburn, Humans, Long-gap esophageal atresia, Long-term morbidity, Morbidity, Postoperative outcomes, Quality of Life, Sweden, Treatment Outcome},
pages = {239},
}
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{"_id":"ifCfvtdFnLHKXqxug","bibbaseid":"dellenmarkblom-rnax-st-svensson-kassa-jnsson-abrahamsson-gatzinsky-etal-postoperativemorbidityandhealthrelatedqualityoflifeinchildrenwithdelayedreconstructionofesophagealatresiaanationwideswedishstudy-2022","author_short":["Dellenmark-Blom, M.","Örnö Ax, S.","Öst, E.","Svensson, J. F.","Kassa, A.","Jönsson, L.","Abrahamsson, K.","Gatzinsky, V.","Stenström, P.","Tollne, A.","Omling, E.","Engstrand Lilja, H."],"bibdata":{"bibtype":"article","type":"article","title":"Postoperative morbidity and health-related quality of life in children with delayed reconstruction of esophageal atresia: a nationwide Swedish study","volume":"17","issn":"1750-1172","shorttitle":"Postoperative morbidity and health-related quality of life in children with delayed reconstruction of esophageal atresia","doi":"10.1186/s13023-022-02381-y","abstract":"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™ 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 \\textless 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 \\textgreater 0.05). More children with DREA underwent esophageal dilatations (both age groups), gastrostomy feeding (2-7 years), and antireflux treatment (8-18 years), p \\textless 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 \\textless 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.","language":"eng","number":"1","journal":"Orphanet Journal of Rare Diseases","author":[{"propositions":[],"lastnames":["Dellenmark-Blom"],"firstnames":["Michaela"],"suffixes":[]},{"propositions":[],"lastnames":["Örnö","Ax"],"firstnames":["Sofie"],"suffixes":[]},{"propositions":[],"lastnames":["Öst"],"firstnames":["Elin"],"suffixes":[]},{"propositions":[],"lastnames":["Svensson"],"firstnames":["Jan","F."],"suffixes":[]},{"propositions":[],"lastnames":["Kassa"],"firstnames":["Ann-Marie"],"suffixes":[]},{"propositions":[],"lastnames":["Jönsson"],"firstnames":["Linus"],"suffixes":[]},{"propositions":[],"lastnames":["Abrahamsson"],"firstnames":["Kate"],"suffixes":[]},{"propositions":[],"lastnames":["Gatzinsky"],"firstnames":["Vladimir"],"suffixes":[]},{"propositions":[],"lastnames":["Stenström"],"firstnames":["Pernilla"],"suffixes":[]},{"propositions":[],"lastnames":["Tollne"],"firstnames":["AnnaMaria"],"suffixes":[]},{"propositions":[],"lastnames":["Omling"],"firstnames":["Erik"],"suffixes":[]},{"propositions":[],"lastnames":["Engstrand","Lilja"],"firstnames":["Helene"],"suffixes":[]}],"month":"June","year":"2022","keywords":"Child, Cough, Delayed reconstruction, Esophageal Atresia, Esophageal atresia, Health-related quality of life, Heartburn, Humans, Long-gap esophageal atresia, Long-term morbidity, Morbidity, Postoperative outcomes, Quality of Life, Sweden, Treatment Outcome","pages":"239","bibtex":"@article{dellenmark-blom_postoperative_2022,\n\ttitle = {Postoperative morbidity and health-related quality of life in children with delayed reconstruction of esophageal atresia: a nationwide {Swedish} study},\n\tvolume = {17},\n\tissn = {1750-1172},\n\tshorttitle = {Postoperative morbidity and health-related quality of life in children with delayed reconstruction of esophageal atresia},\n\tdoi = {10.1186/s13023-022-02381-y},\n\tabstract = {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.\nMETHODS: Postoperative morbidity, age-specific generic HRQOL (PedsQL™ 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 {\\textless} 0.05.\nRESULTS: 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 {\\textgreater} 0.05). More children with DREA underwent esophageal dilatations (both age groups), gastrostomy feeding (2-7 years), and antireflux treatment (8-18 years), p {\\textless} 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 {\\textless} 0.05.\nCONCLUSIONS: 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.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {Orphanet Journal of Rare Diseases},\n\tauthor = {Dellenmark-Blom, Michaela and Örnö Ax, Sofie and Öst, Elin and Svensson, Jan F. and Kassa, Ann-Marie and Jönsson, Linus and Abrahamsson, Kate and Gatzinsky, Vladimir and Stenström, Pernilla and Tollne, AnnaMaria and Omling, Erik and Engstrand Lilja, Helene},\n\tmonth = jun,\n\tyear = {2022},\n\tkeywords = {Child, Cough, Delayed reconstruction, Esophageal Atresia, Esophageal atresia, Health-related quality of life, Heartburn, Humans, Long-gap esophageal atresia, Long-term morbidity, Morbidity, Postoperative outcomes, Quality of Life, Sweden, Treatment Outcome},\n\tpages = {239},\n}\n\n\n\n","author_short":["Dellenmark-Blom, M.","Örnö Ax, S.","Öst, E.","Svensson, J. 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