Respiratory Outcomes in Children Born With Esophageal Atresia With or Without Tracheoesophageal Fistula: A Retrospective Longitudinal Cohort Study
Bibliographic record
Abstract
BACKGROUND: The respiratory health of children born with esophageal atresia with or without tracheoesophageal fistula (EA/TEF) can be compromised. PURPOSE: We aimed to study how respiratory outcomes in EA/TEF cases change with increasing age and over time. METHODS: We performed a retrospective cohort study of children with EA/TEF treated in our centre from 1991 to 2022 and compared their respiratory outcomes to those of date-of-birth matched controls. Respiratory outcomes up to 2022 were identified using International Classification of Diseases codes (ICD-9). Odds ratios (OR), rate ratios (RaR) and Cox proportional hazard models were used to compare acute respiratory infections (ICD-9:460-466), asthma (ICD-9:493), bronchitis (ICD-9:490-491), influenza (ICD-9:487-488), and pneumonia (ICD-9:480-486) between cases and controls. RESULTS: A total of 95 cases and 945 controls were included. Cases were more likely to have asthma (OR = 2.32, 95%CI = 1.51,3.58) and pneumonia (OR = 5.94, 95%CI = 2.37,3.65) compared to controls. Cases had more episodes of acute respiratory tract infections and bronchitis (RaR = 1.45, 95%CI = 1.32,1.58; RaR = 13.3, 95%CI = 11.2,15.9, respectively). Influenza was unaffected by EA/TEF status. By late adolescence, new or recurrent episodes of respiratory disorders were uncommon, except for acute respiratory tract infections which continued to recur more often in cases than controls into adulthood. EA/TEF survivors born in recent years experienced fewer respiratory complaints than those born in the remote past. CONCLUSION: Although the respiratory outcomes of children with EA/TEF were worse than controls, survivors can expect improved pulmonary health as they approach maturity, and respiratory health is improving for the contemporaneous EA/TEF population. LEVEL OF EVIDENCE: Prognostic, Level III.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".