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Oral Presentation - 21
The relationship between nutritional status and surgical outcomes in patients with esophageal atresia: Findings from the Turkish Esophageal Atresia Registry
T Soyer 1, S Arif Bostancı 2, Ç Ulukaya Durakbaşa 3, C Özcan 4, İ Çiftçi 5, G Göllü 6, A Parlak 7, EB Çığşar Kuzu 8, BD Demirel 9, İ Akkoyun 10, B Fırıncı 11, G Şalcı 12, O Devrim Ayvaz 13, A Şencan 14, H İlhan 15, G Kıyan 16, AE Hakalmaz 17, A Karaman 18, F Saraç 19, ŞS Kılıç 20, O Uzunlu 21, A Temiz 22, E Özçakır 23, B Erginel 24, A Yıldız 25, AO Erdem 26, S Sancar 27, A Süzen 28, A Atıcı 29, S Özaydın 30, E Yeşildağ 31, MA Özen 32, O Dağ 33
1 Department of Pediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkiye
2 Ankara Bilkent City Hospital Department of Pediatric Surgery, Ankara
3 Department of Pediatric Surgery Istanbul Medeniyet University Faculty of Medicine Goztepe Prof Dr Suleyman Yalcin Sehir Hastanesi, Istanbul
4 Department of Pediatric Surgery, Faculty of Medicine, Ege University, Izmir, Turkey
5 Department of Pediatric Surgery, Selçuk University School of Medicine, Konya, Turkey
6 Ankara University Cebeci Hospital Department of Pediatric Surgery
7 Bursa Uludag University, Faculty of Medicine, Department of Pediatric Surgery
8 Department of Pediatric Surgery, İzmir Katip Çelebi University School of Medicine, İzmir, Turkey
9 Ondokuz Mayıs University department of Pediatric Surgery
10 Department of Pediatric Surgery, Konya Education and Research Hospital, Konya, Turkey
11 Ataturk University School of Medicine, Department of Pediatric Surgery, Erzurum
12 Karadeniz Technical University Faculty of Medicine Department of Pediatric Surgery
13 Zekai Tahir Burak Maternity and Teaching Hospital, Pediatric Surgery, Ankara
14 Dr. Behçet Uz Child Diseases and Surgery Training and Research Hospital, Pediatric Surgery Clinic
15 Eskisehir Osmangazi Uiversity, School of Medicine, Department of Pediatric Surgery
16 Marmara University School of Medicine, Departmant of Pediatric Surgery,
17 Istanbul University Cerrahpasa Medical Faculty Department of Pediatric Surgery
18 Dr. Sami Ulus Maternity and Children Training and Research Hospital, Department of Pediatric Surgery, Ankara
19 Basaksehir Cam and Sakura City Hospital Department of Pediatric Surgery, Istanbul, Turkey. Pediatric Surgery Meta Analysis Group (PESMA), Istanbul, Turkey
20 Cukurova University Faculty of Medicine Department of Pediatric Surgery
21 Pamukkale University Faculty of Medicine Department of Pediatric Surgery, Denizli
22 Baskent University Faculty of Medicine Department of Pediatric Surgery
23 University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Pediatric Surgery
24 Istanbul University Istanbul Medical Faculty Department of Pediatric Surgery
25 Department of Pediatric Surgery, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
26 Adnan Menderes Üniversity School of Medicine Department of Pediatric Surgery
27 Bursa City Hospital, Department of Pediatric Surgery
28 Department of Pediatric Surgery, Faculty of Medicine, Mugla Sıtkı Kocman University, Mugla, Turkey
29 Mustafa Kemal University Faculty of Medicine Department of Pediatric Surgery Hatay
30 Kanuni Education and Research Hospital, Department of Pediatric Surgery
31 Department of Pediatric Surgery, Tekirdağ Namık Kemal University School of Medicine, Tekirdağ, Turkey
32 Koç University, School of Medicine, Department of Pediatric Surgery
33 Hacettepe University Faculty of Medicine, Department of Biostatistics, Ankara, Turkey
Aim: To evaluate the relationship between nutritional status, associated anomalies and surgical outcomes in patients with esophageal atresia (EA) from the Turkish Esophageal Atresia Registry (TEAR) in the first year of life.
Methods: Between 2015-2024, 34 centers registered 1107 patients in TEAR. 713 patients with the complete data of neonatal period and first year-of life were included. Nutritional status of patients was assessed with gestational age and birth weights according to FENTON growth charts and patients were grouped as small-for-gestational-age (SGA, z-scores<10 percentiles), medium-SGA (z-scores=10-20), appropriate-for-gestational-age (AGA, z-scores=20-90) and large-for-gestational-age (LGA, z-scores>90) at birth. The z-scores for height-for-weight were reevaluated at 6th and 12th month-of-age. Nutritional status at birth is compared with 6th and 12th month assessments to define the percent of cases with nutritional improvement, worsened and unchanged.
Results: Among 713 patients, 56% were boys. 23,7% of patients were SGA, 16,8% were medium-SGA, 54,6% were AGA and 4,9% were LGA. There was no difference between groups for demographic features, outcomes and mortality (p>0.05). However, patients with SGA had higher rate of karyotype anomalies (23.1%, p<0.05). At the 6th month, 20% of patients had improved nutritional status, 46,2% unchanged and 33,5% worsened. At the end of first-year-of-life, 31,6% of patients had improved nutritional status, 50,2% unchanged, 18,3% worsened. Patients with worsened nutritional status (10,2%) had a significantly higher rate of mortality (p<0.05). There was no statistical difference between nutritional status and outcomes at 6th and 12th month (p>0.05).
Conclusions: The incidence of SGA was significantly higher in EA patients with karyotype anomalies. While 20% of patients improved nutritional status at the 6th month, one third of patients improved nutritional status at the end of first year. Patients with worsened nutritional status had higher mortality rates.