Time to Death and Predictors among Neonates with Oesophageal Atresia Admitted at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia, 2021.

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Addis Abeba University


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.



Esophageal atresia, time to death, neonatal intensive care unit, Ethiopia