Neurodevelopmental outcomes of tracheoesophageal fistulas

• Published in: Journal of pediatric surgery Vol. 51; no. 5; pp. 743 - 747
• Main Authors: Newton, Laura Elyce, Abdessalam, Shahab F, Raynor, Stephen C, Lyden, Elizabeth R, Rush, Eric T, Needelman, Howard, Cusick, Robert A
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2016
• Subjects: Case-Control Studies; Child, Preschool; Developmental Disabilities - diagnosis; Developmental Disabilities - etiology; Developmental Disabilities - therapy; Early Intervention (Education); Female; Follow-Up Studies; Humans; Infant; Infant, Newborn; Male; Neurodevelopment; Outcomes; Pediatrics; Referral and Consultation - statistics & numerical data; Retrospective Studies; Risk Factors; Surgery; Tracheoesophageal fistula; Tracheoesophageal Fistula - complications; Tracheoesophageal Fistula - surgery; Tracheoesophageal Fistula; Neurodevelopment; Outcomes; Tracheoesophageal fistula
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2016.02.015

Abstract Purpose The purpose of this study was to perform a retrospective review of tracheoesophageal fistula (TEF) patients who followed up in a state-sponsored program to assess neurodevelopmental outcomes. Methods Records were reviewed retrospectively of children who underwent TEF repair between August 2001 and June 2014. Children discharged from the neonatal intensive care unit were referred to the state-sponsored Developmental Tracking Infant Progress Statewide (TIPS) program. We reviewed TIPS assessments performed before age 24 months and noted referral for early school intervention services. Poor outcomes were defined as scores of “failure” on the screening assessment or referral for enrollment in early intervention services by 24 months. Children with TEF were compared with case-matched nonsyndromic children of similar gestational age and birth weight. Results Seventy-eight children underwent TEF repair. Thirty-eight followed up with TIPS. Survival was 93.6%. Predictors of hospital survival were Waterston classification (p = 0.001), birth weight (p = 0.027), and ventilator days (p = 0.013). LOS was the only significant predictor of referral for early intervention services (p = 0.0092) in multivariate analysis. There was a borderline significant difference in referral rate between children with TEF and controls. 52.6% of TEF patients were referred, while 34.2% of controls were referred (p = 0.071). Conclusion Over half of TEF patients experience neurodevelopmental delays requiring referral for early intervention (53%).