Clinical Factors Affecting Condition-Specific Quality-of-Life Domains in Pediatric Patients after Repair of Esophageal Atresia: The Swedish-German EA-QOL Study

Michaela Dellenmark-Blom; Julia Quitmann; Jens Dingemann; Stefanie Witt; Benno M. Ure; Monika Bullinger; Linus Jönsson; Vladimir Gatzinsky; Carmen Dingemann

doi:10.1055/s-0039-1693729

European Journal of Pediatric Surgery, Table of Contents

Eur J Pediatr Surg 2020; 30(01): 096-103
DOI: 10.1055/s-0039-1693729

Original Article

Georg Thieme Verlag KG Stuttgart · New York

Clinical Factors Affecting Condition-Specific Quality-of-Life Domains in Pediatric Patients after Repair of Esophageal Atresia: The Swedish-German EA-QOL Study

Michaela Dellenmark-Blom

¹Department of Pediatrics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden

²Department of Pediatric Surgery, The Queen Silvia Children’s Hospital, Gothenburg, Sweden

,

Julia Quitmann

³Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

,

Jens Dingemann

⁴Department of Pediatric Surgery, Hannover Medical School, Hannover, Niedersachsen, Germany

,

Stefanie Witt

³Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

,

Benno M. Ure

⁴Department of Pediatric Surgery, Hannover Medical School, Hannover, Niedersachsen, Germany

,

Monika Bullinger

³Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

,

Linus Jönsson

²Department of Pediatric Surgery, The Queen Silvia Children’s Hospital, Gothenburg, Sweden

,

Vladimir Gatzinsky

²Department of Pediatric Surgery, The Queen Silvia Children’s Hospital, Gothenburg, Sweden

,

Carmen Dingemann

⁴Department of Pediatric Surgery, Hannover Medical School, Hannover, Niedersachsen, Germany

› Author Affiliations

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.

Keywords

esophageal atresia - quality of life - health-related quality of life - pediatric surgery - children

Full Text

References

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Supplementary Material