Esophageal atresia with tracheoesophageal fistula and early postoperative mortality
Bibliographic record
Abstract
Background: Several recent reports showed that associated anomalies represent the main cause of postoperative mortality in infants born with esophageal atresia (EA) and/or tracheoesophageal fistula (TEF). Our observations present additional causes of mortality to the above mentioned. The aim of this study is to identify the major causes of early postoperative mortality in cases of EA and/or TEF in our setup. The ongoing preoperative classifications predicting mortality will be also used for comparison. Patients and methods: We reviewed 101 charts of all cases with EA and/or TEF in a period of 11 years from 1990 to 2000. Morbidity and causes of postoperative mortality during the first admissions were identified. The factors predicting mortality were documented. Patients were classified according to Waterston, Montreal and Spitz classifications. Results: Thirty-one patients (30.7%) died. Two main groups of post operative mortality were identified. The first group included the possibly avoidable causes of mortality which were primary sepsis (n=10, 32.3%), technical problems (n=8,25.8%) and severe pneumonia (n=5,16.1%). The unavoidable causes of mortality included major congenital anomalies (n=6, 19.3%) and anomalies incompatible with life (n=2, 6.5%). Conclusion: Primary sepsis and sepsis due to technical problems were the main causes of mortality in our series. Factors predicting mortality were pneumonia at presentation, sepsis at presentation or that acquired during hospitalization, major or life threatening anomalies, long gaps and major leaks. The Waterston classification was statistically the best applicable in this study. Key-words: Esophageal atresia, Tracheosopheal fistula, Mortality, Risk factors - congenital anomalies, Sepsis. RésuméIntroduction: Des rapports diverses récents avaient indiqués que les anormalies liées représentent la cause principale de la mortalite postopératoire chez des enfants nés atteints d'atresie oesophage (AO) et / ou fistule tracheoesophage (FTO) Nos observations donnent des causes supplementaires de la mortalité en plus des causes citées ci-dessus. L'objet de cette étude est d'identifier les causes principales de la mortalite postopératoire dans les cas de AO et / ou FTO dans notre programme. On va également utiliser cette classification préopératoire qui prédit le taux de la mortalité de faire la comparaison nécessaire. Patients et methods: Nous avons fait le bilan de 101 graphiques de tous les cas atteints de AO et / ou FTO d'une durée de 11 ans de 1990 au 2000. Mobidité et causes de la mortalité postopératoire pendant la première admission ont été identifiés. Des facteurs qui prédéterminent la mortalité ont été documentés. Les patients ont été groupés selon les classification de Waterton, Montreal et Spitz. Résultat: Trente et un patients soit 30,7% étaient morts. On avait identifié deux groupes majeurs de la mortalité post opératoire. Le premier groupe comprend les causes possible de la mortalité évitable qui étaient le sepsis premaire (n = 10, 32, 3%), problème techniques (n = 8,25,8%) et pneumonie grave (n = 5, 16, 1%). Les causes inèvitables de la mortalité comprend des anormalies congénitales principales, (n = 6, 19,3%) et anormalies incompatibles avec la vie (n = 2,6,5%). Conclusion: Sepsis primaire et sepsis provoqué par des problèmes techniques étaient les causes principales de la mortalité dans nos séries. Des facteurs qui prédéterminent la mortalité était la pneumonie et présentation, septicité au cours de la présentation ou bien septicite acquise pendant l'hôpitalization, majeur ou bien des anormalies qui menacent la vie, un écart long et des fuites principales statisquement, la classification de Waterston était la meilleur utilisée dans cette étude. West African Journal of Medicine Vol. 24(1) 2005: 311-315
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".