title: [Mortality in patients with esophageal atresia: influence of birth weight and cardiac anomaly].
abstract: BACKGROUND
  Waterston's prognostic classification of esophageal atresia has been used in most hospitals throughout the world. A number of technical advances, mainly in neonatal intensive care units have contributed to a reduction in mortality. Although the Waterston classification continues to be widely used, increased survival in the highest risk groups in this classification has led to new classifications being described in the last few years.
  
  
  OBJECTIVE
  To determine the influence of birth weight and cardiac anomaly on the outcome of patients with esophageal atresia.
  
  
  METHODS
  The outcome of 100 infants with esophageal atresia was analyzed. The patients were divided chronologically into two groups according to advances in ICUs and surgical techniques: 45 patients treated in the first period (1971-1982) and 55 in the second (1983-2000). The influence of birth weight in the groups described by Waterston and Spitz and the association with cardiac malformation were compared between both periods.
  
  
  RESULTS
  Mortality in the birth weight groups described by Waterston decreased significantly between periods but this decrease was lower when the birth weight groups at highest risk described by the Spitz (1,500 g) were compared. Survival in patients with esophageal atresia improved from the first period (57.8 %) to the second (80 %) but mortality was still high when an associated major cardiac anomaly was present (80 % vs 75 %).
  
  
  CONCLUSIONS
  Although advances in the medical and surgical management of neonates have rendered birth weight less important to prognosis than previously, mortality continues to be high in patients with very low weight and major cardiac malformation.
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Infantil Universitario Miguel Servet. Zaragoza.
authors.forename: C
authors.initials: C
authors.lastname: Pueyo Gil
authors.forename: J
authors.initials: J
authors.lastname: Elías Pollina
authors.forename: N
authors.initials: N
authors.lastname: González Martínez Pardo
authors.forename: M
authors.initials: M
authors.lastname: Ruiz De Temiño
authors.forename: R
authors.initials: R
authors.lastname: Escartín Villacampa
authors.forename: J
authors.initials: J
authors.lastname: Esteban Ibarz
mesh_terms: D000015:Abnormalities, Multiple; D001724:Birth Weight; D004933:Esophageal Atresia / Q000401:mortality*; D005260:Female; D006330:Heart Defects, Congenital; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011379:Prognosis