Assessment Of The Outcomes Of Neonates With The Diagnosis Of Esophageal Atresia And/Or Tracheoesophageal Fistula Admitted To Tikur Anbessa Specialized HospitalNeonatal Intensive Care Unit

Abstract

Background:
Esophageal atresia and/or tracheoesophageal fistula are a fairly common congenital anomaly which is
associated with serious morbidity and high rate of mortality in newborns.
Objective:
To assess the outcomes of neonates with the diagnosis of esophageal atresia and/or tracheoesophageal
fistula (EA and/or TEF) admitted to Tikur Anbessa Specialized Hospital, Neonatal Intensive Care Unit
(TASH-NICU) from Sep., 2008 to Aug., 2013.
Methodology:
This is a retrospective study in which clinical records of all neonates admitted to TASH-NICU with the
diagnosis of EA and/or TEF from Sep., 2008 to Aug., 2013 were retrieved and those newborns whose
charts had been filled with necessary information were selected as study subjects. A structured
questionnaire was used to collect necessary data about each case. Outcome, possible determinant factors
of outcome, associated congenital anomalies, treatment provided, and complications were analyzed.
Results:
About 41 cases of EA and/or TEF were admitted to TASH-NICU during the study period. There were 34
eligible cases. Some of the cases whose charts were lost or incompletely filled were excluded from the
study. Among the eligible ones, 19 (55.9%) were females and 15 (44.1%) were males. There were only
5(14.7%) newborns that were discharged alive. Most died during the neonatal age (85.3%). Surgical
intervention was performed for only half of the cases. Aspiration pneumonia was the most common
reason for delayed surgical intervention. It was also the leading cause of respiratory failure and death of
the newborns. There was a strong association between mortality and birth weight (P-value < 0.05).
Conclusion
This study showed that most cases of EA and/or TEF admitted to TASH-NICU died during neonatal age.
Low birth weight has been strongly associated with higher risk of mortality in neonates with the diagnosis
of EA and/or TEF.
Supportive care provided to newborns with EA and/ or TEF was not sufficient as it didn’t include lifesaving treatments like mechanical ventilation and total parenteral nutrition.