■已经提出了基于各种术前因素的几种风险分类来预测食管闭锁手术儿童的即时生存。这些分类的主要缺点是它们仅关注即时生存,而忽略了这些儿童的长期发病率和死亡率。我们的研究旨在通过研究一种此类分类(冈本分类)对食管闭锁手术患者出院后1年的死亡率和发病率的影响来弥合这一知识差距。
■经过机构道德审查,对2012年至2015年间因食管闭锁-气管瘘手术的106名儿童在出院后1年进行了前瞻性研究。根据冈本分类对儿童进行分级。主要目标是确定该分类在预测婴儿期生存率方面的功效,次要目标是根据分类比较这些儿童的并发症发生率。
■69名儿童符合纳入标准。冈本一班有40、15、10和4个孩子,II,III,IV,分别。随访期间有21名患者(30%)死亡,其中冈本IV级死亡人数最高(75%),冈本I级死亡人数最低(17.5%)(P=0.003)。冈本类别与体重增加不良的发生率之间存在显着相关性(P=0.001),下呼吸道感染(P=0.007),与I和II相比,冈本IV和III的茁壮成长失败(P=0.01)更高。
■冈本初次住院期间的预后分类即使在1年随访时也是相关的,与I类相比,冈本IV类的死亡率和发病率增加
UNASSIGNED: Several risk classifications based on various preoperative factors have been proposed to prognosticate the immediate survival of children operated for esophageal atresia. A major drawback of these classifications is that they only focus on immediate survival while ignoring the long-term morbidity and mortality in these children. Our study aims to bridge this gap in knowledge by studying the impact of one such classification (Okamoto\'s classification) on mortality and morbidity during a period of 1 year after discharge from the hospital in operated cases of esophageal atresia.
UNASSIGNED: After institutes ethical clearance, 106 children operated for esophageal atresia-tracheoesophageal fistula between 2012 and 2015 were studied prospectively for a period of 1 year after their discharge. The children were graded as per Okamoto classification. The primary objective was to determine the efficacy of this classification in predicting the survival rates in infancy and the secondary objective was to compare the complication rates in these children based on the classification.
UNASSIGNED: Sixty-nine children met the inclusion criteria. There were 40, 15, 10, and 4 children in Okamoto Classes I, II, III, and IV, respectively. Twenty-one patients (30%) died during the follow-up period with the maximum number of deaths occurring in Okamoto Class IV (75%) and the minimum in Okamoto Class I (17.5%) (P = 0.003). There was a significant correlation between the Okamoto classes with the incidence of poor weight gain (P = 0.001), lower respiratory tract infection (P = 0.007), and failure to thrive (P = 0.01) higher in Okamoto IV and III as compared to I and II.
UNASSIGNED: Okamoto prognostic classification during the initial hospitalization is relevant even at 1 year follow-up with increased mortality and morbidity in Okamoto Class IV as compared to Class I.