Oesophageal atresia: At-risk groups for the 1990s

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Abstract

The authors analyzed the outcome for 357 infants with oesophageal atresia and 15 with H-type tracheooesphageal fistula treated from 1980 through 1992. Survival according to Waterston risk categories was 99% for group A, 95% for group B, and 71% for group C. Presently, with optimal management, virtually all infants in groups A and B should survive. When examining the risk factors in the infants who died, two criteria were found to be important predictors of outcome: birth weight of less than 1,500 g and the presence of major congenital cardiac disease. A new classification for predicting outcome in oesophageal atresia is proposed: group I: birth weight ≥ 1,500 g, without major cardiac disease, survival 97% (283 of 293); group II: birth weight < 1,500 g, or major cardiac disease, survival 59% (41 of 70); and group III: birth weight < 1,500 g, and major cardiac disease, survival 22% (2 of 9).

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Presented at the 40th Annual International Congress of the British Association of Paediatric Surgeons, Manchester, England, July 21–23, 1993.

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