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Isr Med Assoc J ; 23(9): 569-575, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34472232

RESUMO

BACKGROUND: Aerodigestive clinics are run by interdisciplinary medical and surgical teams, and provide complex care coordination and combined endoscopies. OBJECTIVES: To describe the design and patient population of the first pediatric aerodigestive center in Israel. METHODS: A retrospective single-center cohort study was conducted describing patients followed in the aerodigestive clinic of Schneider Children's Medical Center of Israel, a tertiary pediatric hospital, between its inception in January 2017 and June 2020. RESULTS: During the study period, 100 patients were seen at the combined respiratory and digestive (NoAM) clinic, with a total of 271 visits. Median age at first assessment was 29.5 months (range 3-216). Fifty-six patients (56%) had esophageal atresia and tracheoesophageal fistula. Thirty-nine patients had an identified genetic disorder, 28 had a primary airway abnormality, 28 were oxygen dependent, and 21 were born premature. Fifty-two patients underwent triple endoscopy, consisting of flexible bronchoscopy, rigid bronchoscopy, and gastroscopy. In 33 patients, esophageal dilatation was necessary. Six patients underwent posterior tracheopexy at a median of 6 months of age (range 5 days to 8 years) all with ensuing symptom improvement. The total mean parental satisfaction score on a Likert-type scale of 1-5 (5 = highest satisfaction) was 4.5. CONCLUSIONS: A coordinated approach is required to provide effective care to the growing population of children with aerodigestive disorders. The cross fertilization between multiple disciplines offers a unique opportunity to develop high quality and innovative care. Outcome measures must be defined to objectively measure clinical benefit.


Assuntos
Doenças do Sistema Digestório/terapia , Endoscopia/métodos , Equipe de Assistência ao Paciente/organização & administração , Assistência ao Paciente/métodos , Doenças Respiratórias/terapia , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Doenças do Sistema Digestório/fisiopatologia , Hospitais Pediátricos/organização & administração , Humanos , Lactente , Israel , Pais/psicologia , Assistência ao Paciente/normas , Equipe de Assistência ao Paciente/normas , Satisfação do Paciente , Qualidade da Assistência à Saúde , Doenças Respiratórias/fisiopatologia , Estudos Retrospectivos , Centros de Atenção Terciária/organização & administração
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