Browsing by Author "Nurminen, Paula"

Introduction: Esophageal atresia (EA) is associated with significant respiratory mortality. We aimed to assess incidence and predictive factors of EA associated pneumonia during the first 5 years of life. Materials and Methods: Institutional ethical consent was obtained. Hospital records of patients with EA from 2002 to 2017 were reviewed. Episodes of pneumonia that were diagnosed in university or regional hospitals were included. For instance, acute respiratory infections other than pneumonia, anastomotic complications, aortopexy, fundoplication and EA anastomosis dilatations were tested as potential risk factors. Results: 104 patients were included. 35 (34%) patients had 94 episodes of pneumonia corresponding to median 2 (IQR 1–4) and 609 episodes per thousand patient years. Majority of pneumonias occurred before the age of 3 years. The cause of pneumonia could be identified as respiratory syncytial virus in 15 (16%) and aspiration in 7 (7.4%) episodes. In univariate analysis, pneumonia was predicted by occurrence and number of nonpneumonia respiratory infections, anastomotic reoperations, fundoplication, and number of EA anastomosis dilatations. In multivariate logistic regression analysis, significant risk factors for pneumonia were occurrence of nonpneumonia respiratory infections and number of anastomotic dilatations. Conclusion: Episodes of pneumonia occurred in one-third of patients. The incidence of pneumonia was highest during the first 3 years. Patients with nonpneumonia respiratory infections and high number of dilatations were at the greatest risk.