title: Morbidity and mortality in patients with esophageal atresia.
abstract: BACKGROUND
  This study reports national estimates of population characteristics and outcomes for patients with esophageal atresia with or without tracheoesophageal fistula (EA/TEF) and evaluates the relationships between hospital volume and outcomes.
  
  
  METHODS
  Patients admitted within 30 days of life who had International Classification of Diseases, 9th Edition, Clinical Modification diagnosis and procedure codes relevant to EA/TEF during 1999-2012 were identified with the Pediatric Health Information System database. Baseline demographics, comorbidities, and postoperative outcomes, including predictors of in-hospital mortality, were examined up to 2 years after EA/TEF repair.
  
  
  RESULTS
  We identified 3,479 patients with EA/TEF treated at 43 children's hospitals; 37% were premature and 83.5% had ≥1 additional congenital anomaly, with cardiac anomalies (69.6%) being the most prevalent. Within 2 years of discharge, 54.7% were readmitted, 5.2% had a repeat TEF ligation, 11.4% had a repeat operation for their esophageal reconstruction, and 11.7% underwent fundoplication. In-hospital mortality was 5.4%. Independent predictors of mortality included lower birth weight, congenital heart disease, other congenital anomalies, and preoperative mechanical ventilation. There was no relationship between hospital volume and mortality or repeat TEF ligation.
  
  
  CONCLUSIONS
  This study describes population characteristics and outcomes, including predictors of in-hospital mortality, in EA/TEF patients treated at children's hospitals across the United States. Across these hospitals, rates of mortality or repeat TEF ligation were not dependent on hospital volume.
authors.affiliation: Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Department of Surgery, Nationwide Children's Hospital, Columbus, OH.
authors.forename: Jason P
authors.initials: JP
authors.lastname: Sulkowski
authors.affiliation: Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH.
authors.forename: Jennifer N
authors.initials: JN
authors.lastname: Cooper
authors.affiliation: Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Lopez
authors.affiliation: Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH.
authors.forename: Yamini
authors.initials: Y
authors.lastname: Jadcherla
authors.affiliation: Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH.
authors.forename: Alissabeth
authors.initials: A
authors.lastname: Cuenot
authors.affiliation: Department of Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Peter
authors.initials: P
authors.lastname: Mattei
authors.affiliation: Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Department of Surgery, Nationwide Children's Hospital, Columbus, OH.
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Deans
authors.affiliation: Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Department of Surgery, Nationwide Children's Hospital, Columbus, OH. Electronic address: peter.minneci@nationwidechildrens.org.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Minneci
mesh_terms: D015331:Cohort Studies; D015897:Comorbidity; D004933:Esophageal Atresia / Q000401:mortality* / Q000601:surgery*; D005260:Female; D017052:Hospital Mortality; D006776:Hospitals, Pediatric; D006801:Humans; D007231:Infant, Newborn; D008026:Ligation; D008297:Male; D009017:Morbidity; D012086:Reoperation; D012189:Retrospective Studies; D014138:Tracheoesophageal Fistula / Q000401:mortality; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology