Intestinal atresias: factors affecting clinical outcomes.
BACKGROUND
Despite improvements in care, intestinal atresias are associated with prolonged hospitalization and occasionally mortality. Although each type of atresia is distinct, it is unclear which factors impact clinical course. This study seeks to identify predictors of untoward outcome.


METHODS
Neonates with duodenal, jejunal/ileal, and colonic atresia, treated at 1 institution from 1982 to 2005 were reviewed. Data were evaluated using nonparametric analysis of variance and logistic regression. Nonparametric data were expressed as medians with interquartile range (IQR).


RESULTS
A total of 132 infants were evaluated including 63 with duodenal, 60 with jejunal/ileal, and 9 with colonic atresias. Overall mortality was 7% with associated congenital anomalies identified as an independent risk factor (P = .01). Infants with associated anomalies were more likely to have low birth weight (2.3 +/- 0.8 vs 3.0 +/- 0.8 kg, P = .01), which further increased mortality risk. Atresia location did not affect mortality or length of stay; however it did impact the time to full enteral nutrition with jejunal atresia requiring longer than duodenal (17 [IQR, 9-40 days] vs 10 [IQR, 7-70 days]; P = .01).


CONCLUSIONS
Overall mortality from intestinal atresia is low and is not dependent on the location of obstruction. Infants with birth weight less than 2 kg and associated anomalies are at an increased risk for prolonged hospital stay and mortality.
Piper
Hannah G
HG
Department of Surgery, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA. hgpiper@interchange.ubc.ca
Alesbury
Julia
J
Waterford
Stephen D
SD
Zurakowski
David
D
Jaksic
Tom
T
D000015:Abnormalities, Multiple / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007409:Intestinal Atresia / Q000453:epidemiology / Q000401:mortality* / Q000601:surgery; D008297:Male; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome