Time to Death and Predictors among Neonates with Oesophageal Atresia Admitted at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia, 2021.
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Date
2021-05
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Abeba University
Abstract
Background -Esophageal atresia is a developmental defect of the upper gastrointestinal tract in
which the continuity between the upper and lower esophagus is lost. In sub-Saharan Africa
esophageal atresia has a higher mortality rate ranging from 30- 80%. In Ethiopia, the mortality
of neonates with esophageal atresia is reported as 85.3%. To decrease the mortality rate,
assessing time to death and predicors of esophageal atresia is crucial.
Objective -The objective of this study was to assess time to death and predictors among
neonates with esophageal atresia admitted to Tikur Anbesa Specialized Hospital.
Methodology -An institutional-based retrospective follow-up study was conducted among 248
neonates diagnosed with esophageal atresia. Data was collected from February 10 to March 10
/2021 by reviewing medical charts of neonates diagnosed with OA who were registered from
March 1/2011- February 30/2021 in TASH. A data extraction format was developed by
reviewing different literature. Time to death was estimated by using the Kaplan-Meier failure
curve and the time to death between different categorical variables was compared using the logrank
test.
Bivariate
and
multivariable
cox
regression
hazards
models
were
fitted
to
identify
the
predictors
of
time
to
death.
Hazard
ratio
with
a
95%
confidence
interval
was
calculated
and
pvalues
<
0.05
were
considered
statistically
significant.
Result
Among 225(90.7%) study subjects, 71.1% have died. Birth weight <2500g (AHR=1.49, 95%CI,
1.02 -2.21), sepsis (AHR=1.67,95%CI, 1.15 - 2.44), malnutrition (AHR=1.61, 95%CI, 1.03 -
2.58), time of fistula repair (AHR=3.72, 95%CI, 1.34- 10.38), diagnosis time (AHR=1.48,
95%CI, 1.01- 2.15) and dehydration (AHR=2.38, 95%CI, 1.63 - 3.46) were found to be
significant predictors of time to death. The median time to death was 11 days (95%CI, 8.9213.08).
Conclusion
-In
this
study,
the
proportion
of
death
among
neonates
diagnosed
with
esophageal
atresia
is
high
as
compared
to
other
studies.
Among
the
deaths
76.9
%
have
died
within
14
days
of
admission. Early diagnosis, appropriate management of comorbidities, and timely surgical intervention
will be helpful to overcome the high mortality rate.
Description
Keywords
Esophageal atresia, time to death, neonatal intensive care unit, Ethiopia