Duodenal Atresia in Finland from 2004 to 2017: Prevalence, Mortality, and Associated Anomalies—A Population-Based Study

Suvi Alikärri; Ilkka Helenius; Susanna Heiskanen; Johanna Syvänen; Teemu Kemppainen; Eliisa Löyttyniemi; Mika Gissler; Arimatias Raitio

doi:10.1055/a-2338-5873

European Journal of Pediatric Surgery, Table of Contents

Eur J Pediatr Surg 2024; 34(06): 544-549
DOI: 10.1055/a-2338-5873

Original Article

Duodenal Atresia in Finland from 2004 to 2017: Prevalence, Mortality, and Associated Anomalies—A Population-Based Study

Suvi Alikärri

¹Department of Paediatric Surgery, Orthopaedics and Traumatology, University of Turku and Turku University Hospital, Turku, Finland

²Department of Surgery, Kanta-Häme Central Hospital, Hämeenlinna, Finland

,

Ilkka Helenius

¹Department of Paediatric Surgery, Orthopaedics and Traumatology, University of Turku and Turku University Hospital, Turku, Finland

³Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

,

Susanna Heiskanen

¹Department of Paediatric Surgery, Orthopaedics and Traumatology, University of Turku and Turku University Hospital, Turku, Finland

,

Johanna Syvänen

¹Department of Paediatric Surgery, Orthopaedics and Traumatology, University of Turku and Turku University Hospital, Turku, Finland

,

Teemu Kemppainen

⁴Department of Biostatistics, University of Turku and Turku University Hospital, Turku, Finland

,

Eliisa Löyttyniemi

⁴Department of Biostatistics, University of Turku and Turku University Hospital, Turku, Finland

,

Mika Gissler

⁵Knowledge Brokers, Finnish Institute of Health and Welfare, Helsinki, Finland

⁶Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden and Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden

,

Arimatias Raitio

¹Department of Paediatric Surgery, Orthopaedics and Traumatology, University of Turku and Turku University Hospital, Turku, Finland

› Author Affiliations

Abstract

Introduction Duodenal atresia (DA) is the most common atresia of the small bowel. This study aims to assess the prevalence, mortality, and associated anomalies related to DA in Finland from 2004 to 2017.

Material and Methods A nationwide study based on registers maintained by the Finnish Institute for Health and Welfare and Statistics Finland containing data on all live births and stillbirths and terminations of pregnancy. The cases were identified based on the ICD-9 and 10 (International Classification of Diseases revisions 9 and 10) codes. Associated anomalies were classified based on the EUROCAT criteria; minor anomalies were excluded.

Results There were 249 DA cases including 222 (89.2%) live births, 16 (6.4%) stillbirths, and 11 (4.4%) terminations. There was no significant change in the prevalence rates between 2004 and 2017. Live birth prevalence was 2.75/10,000 and total prevalence was 3.08/10,000 births. A total of 100 (40.2%) cases were isolated, 67 (26.9%) had other multiple congenital anomalies, and 83 (33.3%) were syndromic. There were no terminations in isolated DA. Most associated anomalies were cardiac (36.1%), followed by other gastrointestinal tract anomalies (23.7%) and limb deformities/defects (7.2%). Trisomy 21 was observed in 63 cases (25.3%). Neonatal mortality was 3.6% (n = 8) and at 1 year 95.0% were alive. Both neonatal and infant mortalities were associated with cardiac anomalies (p < 0.001 and p = 0.001, respectively). All neonatal deaths had associated cardiac defect(s).

Conclusions The prevalence of DA in Finland remains stable and among the highest reported. DA is often associated with cardiac anomalies, which portend a high risk for mortality. Despite the burden of associated anomalies, overall survival is high.

Keywords

duodenal atresia - mortality - prevalence - associated anomalies

Full Text

References

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