1. Clinical Factors Affecting Condition-Specific Quality-of-Life Domains in Pediatric Patients after Repair of Esophageal Atresia: The Swedish-German EA-QOL Study.
- Author
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Dellenmark-Blom, Michaela, Quitmann, Julia, Dingemann, Jens, Witt, Stefanie, Ure, Benno M., Bullinger, Monika, Jönsson, Linus, Gatzinsky, Vladimir, and Dingemann, Carmen
- Subjects
WHEEZE ,ESOPHAGEAL atresia ,BODY image ,QUALITY of life ,SOCIAL isolation ,REGRESSION analysis ,RESPIRATORY diseases ,DIGESTIVE system diseases ,MULTIPLE human abnormalities ,SEX distribution ,SEVERITY of illness index ,REOPERATION ,PARENTS ,PSYCHOLOGICAL stress ,DISEASE complications - Abstract
Introduction: We aimed to identify clinical factors affecting condition-specific health related quality of life (HRQOL) domains in children born with esophageal atresia (EA). This can facilitate preventive care to risk groups of HRQOL impairments.Materials and Methods: A total of 124 Swedish and German families of EA children answered the validated EA-QOL questionnaires (response rate 68%), for evaluation of three HRQOL domains in children 2 to 7 years old (53 parents) and four HRQOL domains in children 8 to 17 years old (62 children/71 parents). Clinical data were collected through medical records and a questionnaire. Statistics included between-group analysis, univariable and stepwise multivariable regression analysis, p < 0.05.Results: Between 2 to 7 years, no primary anastomosis (p = 0.022) and female gender (p = 0.026) predicted worse scores related to "physical health and treatment," and gastrostomy insertion related to "eating" (p = 0.0001), and "social isolation and stress" (p = 0.001). Between 8 to 17 years, no primary anastomosis (child report), prematurity, esophageal dilatation (parent report) predicted poor HRQOL related to "eating" (p < 0.05), associated anomalies to "body perception" (p = 0.031, parent report), female gender (p = 0.018, child report) and severe EA (p = 0.011 child report, p = 0.004 parent report) to "social relationships," and severe EA predicted worse "health and well-being" scores (p = 0.004, parent report). An increased number of digestive symptoms (difficulty swallowing food, heartburn, and vomiting), lowered all EA-QOL domain scores in both age groups (p < 0.001). An increased number of respiratory problems (cough, wheezing, airway infections. breathlessness, and chest tightness), lowered scores in two HRQOL domains among children 2 to 7 years (p < 0.05).Conclusion: Impairments within condition-specific HRQOL domains in EA children are found in congenital and surgical subgroups, and notably related to digestive symptoms throughout childhood. [ABSTRACT FROM AUTHOR]- Published
- 2020
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