Impacts of surgical interventions on the long-term outcomes in individuals with trisomy 18.
J Pediatr Surg
; 55(11): 2466-2470, 2020 Nov.
Article
em En
| MEDLINE
| ID: mdl-31954556
ABSTRACT
OBJECTIVE:
We aim to clarify whether surgical interventions can contribute to improve the long-term outcomes among individuals with trisomy 18.METHODS:
We retrospectively studied 69 individuals with trisomy 18 admitted to 4 tertiary neonatal centers between 2003 and 2017. A cohort was divided into two groups subjects with surgical interventions and conservative treatments. We compared the rates of survival and achieving homecare between the groups.RESULTS:
Gestational age and birth weight were 37 (27-43) weeks and 1,700 (822-2,546) g, respectively. There were 68 patients with congenital heart disease and 20 patients with digestive disease. Surgical interventions including cardiac and digestive surgery were provided in 41% of individuals. There was no difference in gestational age (p=0.30), birth weight (p=0.07), gender (p=0.30), and fetal diagnosis (p=0.87) between the groups. During the median follow up duration of 51 (2-178) months, overall survival rates in 6, 12 and 60 months were 57%, 43% and 12%, respectively. Survival to hospital discharge occurred in 23 patients, and the rates of achieving homecare in 1, 6, and 12 months are 1%, 18% and 30%, respectively. There was no significant difference in survival rate (p=0.26) but in the rate of achieving home care (p=0.02) between the groups. Cox hazard analysis revealed that prenatal diagnosis (hazard ratio 0.30, 95%CI 0.13-0.75), cardiac surgery (hazard ratio 2.40, 95%CI,1.03-5.55), and digestive surgery (hazard ratio 1.20, 95%CI 1.25-3.90) were related to the rate of achieving homecare.CONCLUSION:
Aggressive surgical interventions contribute not to the long-term survival but to achieve homecare among individuals with trisomy 18. EVIDENCE LEVEL Level 3 (Prognostic study, Case-Control study).Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Síndrome da Trissomía do Cromossomo 18
Tipo de estudo:
Observational_studies
Limite:
Female
/
Humans
/
Newborn
/
Pregnancy
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article